Most people have no clue about their insurance plan; they pay it when its due and move on. Even when you go and choose your insurance plan most people don’t know what they are choosing, they see price and that’s all. Here are a few things everyone should know.
- Your deductible
Everyone has a deductible on there insurance. This means that you must meet this dollar amount before your insurance will pay anything. So, you as the patient pay at 100% until that amount is met. Once it is met then you start paying your coinsurance amount (unless you have a copay plan). On January 1st of every year everything starts back to zero on deductibles.
- Your co payment
Your copay or coinsurance is either an exact dollar amount or a percentage. Example Medicare pays at 80% of what is billed so most people have a secondary and they pick up the 20% left over. If you do not have a secondary, then its patient responsibility for the 20%. Your co pay or co insurance is due the day you receive treatment. The percentage you pay is based on what the therapist did and billed for you on the day or service.
- Out of pocket max
People normally get these confused with deductibles. Once the out pocket is met the patient doesn’t have to pay the copay or coinsurance anymore that year. Think of this like a step coming down. On top is deductible, once that’s met it goes to copay or coinsurance, then once the out of pocket is met the patient pays nothing. So, patients will continue through the year paying the copay or coinsurance till the out of pocket is met. We love for you to meet your max.
Here at Hohman we hate to bill patients if not needed, we like you to pay at each visit, so you are not surprised at the end of treatment. When we notice that you have met deductible or out of pocket, we change your account immediately and issue refunds after all insurance payment have come in.