There seems to be some confusion about office visit copays and health insurance deductibles work together.
The most common belief is that one must satisfy their deductible before their health insurance kicks in.
This is a misunderstanding.
Lets look at an example:
Plan Deductible: $5000
Office Copay: $30
Prescription Copay: $15
Scenario: Doctors visit for chest congestion. Doctor prescribes prescription.
In this scenario, you would pay $30 for the office visit and $15 for your prescription coverage. Your health insurance plan would cover the additional cost of the office visit and prescription. Yes, even with a $5000 deductible.
The simplest way to understand the plan deductible is to look at it this way:
Your deductible is triggered for Inpatient hospitalization services, Outpatient services, and Emergency room services. Depending on your plan it may also come in to play for x-rays and labs. Always be sure to read your plan documents to fully understand your coverage.
This means if you go to the doctor because you have a bad cold or the flu, you only pay your office visit copay. You do not. I repeat, do not have to satisfy your deductible before you use these benefits.
We wrote about this last year:
Do I Have To Satisfy My Deductible To Use Office Visit Copays?
Originally posted 2010-04-01 06:03:26. Republished by Blog Post Promoter
Tags: copays, deductible, Deductible before insurance kicks in, Office Visit Copay
