Deductibles and copays are both out-of-pocket expenses. Although they both represent a percentage you have to pay when you see a doctor, they are not the same thing. Your copay is a fee you pay when you fill a prescription or receive medical services. The deductible is an agreed amount you must pay before the total cost of your treatment is covered. Your policy defines these details explicitly, so it is important to review the terms carefully.
Understand the difference between deductibles and copays
Health insurance plans often have different fees for different services. For example, a routine check-up is the cheapest service, and a hospital visit is usually the most expensive. In some cases, a copy may not be required. Some plans offer full coverage for routine health checkups, at no cost to you for your doctor̵7;s visit. Your deductible cannot be applied to your deductible. Copays are standard for both HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans.
Although deductibles are an out-of-pocket expense, they are a fixed dollar amount you must pay for covered medical expenses before your health insurance company will begin paying for all or some of your medical services. Some insurance plans may also have multiple deductibles:
- Family Plans: Health insurance plans that cover a family often have two deductibles. One is for the policyholder, and the other is for their immediate family.
- Prescription: If you have a health insurance plan that covers drugs, its deductible may be separate from what you pay for other medical services.
Not all services require you to cover your deductible before your health insurance covers the cost of your care. The following types of preventive care are fully covered by most plans:
- Cancer examinations
- Routine exams
- Periodic preventive health examinations
In general, the lower the premium, the higher the deductible, so don’t assume a cheaper health insurance plan is the best choice. Otherwise, you may have to cover a large deductible before your health insurance provider begins to cover the cost of your treatment.
Do you need help with health insurance?
If you’re looking for the best health insurance for you or your family, it can be a stressful and complicated task to navigate without help. To ensure you get the best coverage at a rate that matches your budget, it’s important to work with an experienced insurance agent to compare plans and costs. Our insurance agents understand how important health insurance is and will work with you to ensure you choose a plan that works best for you or can review your existing health insurance to find a better price or coverage.
Our local agents live and work in the area and are committed to helping our friends and neighbors find the health insurance that makes sense. We are dedicated to customer satisfaction and will provide knowledgeable, friendly and personalized service. Contact one of our local insurance agents today for help finding a plan that works for you.