Question: Can someone explain this to me about deductibles?
Trying to figure out my health insurance and naturallly can’t get anyone on the phone. It says $4000 per person to max $5000 per family. then it says co insurance limit is what you pay out of pocket not including copayments and deductibles once family co-insur is met you are considered as having met coinsurance for the rest of the year. Does this mean the $5000 includes the Deductibles And Copays
Then what are you paying out of pocket besides co pays and deductibles?
Answer: Co-pays are “first dollar” benefits and do not go toward the deductible. You may have a prescription card with co-pay benefits, and it is the same way. Services rendered other than the doctor visits and prescriptions are subject to your deductible. After you have paid $4000 in deductible and coinsurance expenses for the calendar year, the insurance company is paying 100% of expenses. However, you will still have to pay the co-pay when you go to the doctor.
Think of it this way, if you use your insurance to go to the doctor and get a prescription when you are sick, and you have co-pay benefits for these services, you will never realize whether your deductible is $250 or $2500 because you have co-pay first dollar benefits.
I hope this helps clear it up a little.
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