Googly asked in Business & FinanceInsurance · 1 decade ago

I recently bought Health insurance...$2000 deductable....I still don't....?

understand how it works..................suppose I go to doctor, pay co-payment of $50 dollars...would the insurance company pay the rest for that visit...plz. tell me.

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  • 1 decade ago
    Favorite Answer

    YOU NEED TO CALL YOUR INSURANCE COMPANY., EACH COMPANY HANDLES THINGS DIFFERENTLY. DON'T GUESS YOU NEED TO KNOW BEFORE YOU USE IT. CALL THE CUSTOMER SERVICE NUMBER WHICH IS USUALLY ON YOUR INSURANCE CARD. I WOULD ALSO THINK ABOUT KEEP LOOKING FOR ANOTHER INSURANCE COMPANY THAT MIGHT BE BETTER. YOU MAY HAVE CALLED SEVERAL BUT I WOULD KEEP CALLING TILL YOU TALKED TO THEM ALL SO YOU CAN BE SURE YOU ARE GETTTING THE BEST FOR YOUR MONEY

    Source(s): HEALTH CARE WORKER
  • Anonymous
    1 decade ago

    First off, I would recommend you call the Health Insurance Company you purchased the plan from and ask for the "Evidence of Coverage" or commonly known as the "EOC" this is a booklet normally 40-200 pages explaning exactly the plan, this will tell you exactly what is covered and what is not. Every single person who purchases a health plan should ask for a EOC "PRIOR" to buying a health plan. Example, what you are saying above, "Suppose I go to the doctor, pay co-payment of $50.00 dollars..would the insurance company pay the rest for the visit".. Probably not, because most plans say "Dr. visits -copay " which means "speaking to the doctor only" as soon as the doctor gives you a diagnostic or test the copayment part is all over, so basically the 4-10minute meeting you have with the doctor in the small room is 50.bucks, as soon as the doctor calls in the nurse to give you a blood test or x-ray you are paying the rest because you have a 2000. deductible. Now since you purchased a PPO plan make sure you see doctors that our within your network so you can receive the best negotiated fees, this will save you lots of money.

    These are all things your Health Insurance Agent should of made you fully aware of prior to selling you a plan, I hope you did not buy a plan online through a etype brokerage house, these are mainly boiler rooms that employee folks that have little or no experience. You are buying what could prove to be the most important thing in your life, don't make the purchase without lots of research I would advice using a local agent who you can see in person, or at least a brokerage that is open 7 days a week everyday of the year till at least 10pm, what is going to happen if you get sick on saturday, or have a question.

  • 1 decade ago

    You have a $2000 deductible? Okay. Here's what happens - you go see the doctor, they bill the insurance, and then the insurance either puts the visit to the deductible (they tell the doctor how much to bill you for) or they pay the visit. Don't pay the doctor directly before they bill your insurance - that's how you know if you've met the deductible or not.

    Now, if you have a copay - that's often separate from the deductible. Do you have what they call a "cost-sharing" plan? That means that you pay a copay, and then a portion of the visit. (It's some formula they use to figure out how much you pay.) You may just have a deductible for procedures (like lab testing) or just for the hospital.

    Either way - your insurance will send an Explanation of Benefits (EOB) stating exactly what you owe and what it went to. ALWAYS wait for that and insist on seeing it before you pay.

    Source(s): I'm a medical biller
  • 1 decade ago

    Having a $2000 deductible means YOU (not the insurer) pays the first $2000 of that year's medical bills.

    The $50 co-pay only comes into play AFTER you've already paid the first $2000 of your yearly medical bills.

    After you've reached your deductible, THEN for subsequent visits, you will pay a $50 co-pay and the insurance will kick in for the rest.

    One possible exception....this is considered a high deductible plan and most will allow some routine visits and preventative care to be paid by the insurer without having to account for the deductible first. You should check your policy to see if it will pay for this first before satisfying your deductible.

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  • 1 decade ago

    You usually have co-pay to visit the doctor. After you reach yoru deductible ( which seems inordinately high) your company pays a higher percentage.

    For example:

    With my plan our copay is 30 dollars. My deductible is 700. After I reach the 700 dollars the insurance pays 80 percent and I pay 20 percent. My out of pocket max for the year is 2000 dollars. So no matter what I won't pay more than that. However the most the plan will cover is 100,000 dollars in a lifetime.

    Source(s): I administer benefits to employees at my place of employement.
  • 1 decade ago

    The insurance company won't pay any of your medical costs until the bills total more than the $2,000.00 for the year.The first $2,000.00 in expenses each year are your responsibility. The doctors office or hospital will bill the insurance and be instructed to bill you if the deductible hasn't been paid by you for the year. You will also recieve a notice from the insurance company that they haven't paid that bill because the deductible hasn't been paid for the year. Your co-pay does not count toward the deductible.

  • 1 decade ago

    Well, you'll have to read yoru POLICY!! Most of the time, the company doesn't pay out until after you've paid $2,000. You'll have to submit the bills to them, and they won't pay out until you've submitted $2,000 of bills. AFter that, you pay the first $50 (assuming that's your co-pay) of every doctor visit, they pay the rest.

    Source(s): agent, 20+ years
  • Anonymous
    1 decade ago

    You should contact the people who sold you the insurance. Everything else is just a guess.

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