{"id":25921,"date":"2022-12-27T19:08:12","date_gmt":"2022-12-27T19:08:12","guid":{"rendered":"https:\/\/dylanrueff.com\/LSB\/?p=25921"},"modified":"2023-07-28T22:51:07","modified_gmt":"2023-07-28T22:51:07","slug":"copays-coinsurance-and-deductibles","status":"publish","type":"post","link":"https:\/\/ldblifestylebenefits.com\/index.php\/2022\/12\/27\/copays-coinsurance-and-deductibles\/","title":{"rendered":"Copays, Coinsurance, and Deductibles"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<\/p>\n<p class=\"postIntro\">If you\u2019re new to having your own medical insurance plan (or maybe even if you\u2019ve had one for a while), the terminology surrounding how much you have to pay for a given service can be confusing. Let\u2019s look at some of the most important terms that will help you better understand your benefits:<\/p>\n<p><strong>Deductible:<\/strong> A deductible is a fixed amount of money that you have to pay before your insurance starts paying benefits. For example, if your deductible is $2,000, you\u2019ll pay out-of-pocket until you reach that amount, and then your coinsurance will kick in. This amount varies by plan, but typically plans with higher monthly costs have lower deductibles and plans with lower monthly costs have higher deductibles. (Side note: some plans have separate deductibles for prescription benefits, so make sure to check your plan details for this.)<\/p>\n<p><strong>Coinsurance:<\/strong> Coinsurance kicks in once you\u2019ve reached your deductible. Now whenever you have a covered medical expense, you\u2019ll pay coinsurance, which is a set percentage of the total cost, and your insurance will pay the rest.<\/p>\n<p><strong>Copay:<\/strong> This is a set amount you\u2019ll pay for a covered service and varies per service. You may pay copays before you hit your deductible and after; this varies by plan.<\/p>\n<p><strong>Out-of-pocket maximum:<\/strong> This one is a little more self-explanatory. Once you\u2019ve paid this set amount out-of-pocket, your plan will pay 100% for covered services for the rest of the year. Depending on your plan, your deductible may or may not include to your out-of-pocket maximum.<\/p>\n<p>Each plan has different deductibles, coinsurance, copays, and out-of-pocket maximums. It\u2019s important to review your benefits carefully to make sure you know what you\u2019re on the hook for when you receive medical care. Consult your summary plan description for more information.<\/p>\n<p><a href=\"https:\/\/www.bcbsm.com\/index\/health-insurance-help\/faqs\/topics\/how-health-insurance-works\/deductibles-coinsurance-copays.html\">How do deductibles, coinsurance and copays work? | bcbsm.com<\/a><br \/>\n<a href=\"https:\/\/www.healthcare.gov\/choose-a-plan\/your-total-costs\/\">Your total costs for health care: Premium, deductible, and out-of-pocket costs | HealthCare.gov<\/a><\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text] If you\u2019re new to having your own medical insurance plan (or maybe even if you\u2019ve had one for a while), the terminology surrounding how much you have to pay for a given service can be confusing. Let\u2019s look at some of the most important terms that will help you better understand your benefits: Deductible: [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":27003,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[112,25],"tags":[],"class_list":["post-25921","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-2023-january-en","category-benefit-spotlight-en"],"_links":{"self":[{"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/posts\/25921","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/comments?post=25921"}],"version-history":[{"count":1,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/posts\/25921\/revisions"}],"predecessor-version":[{"id":27004,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/posts\/25921\/revisions\/27004"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/media\/27003"}],"wp:attachment":[{"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/media?parent=25921"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/categories?post=25921"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ldblifestylebenefits.com\/index.php\/wp-json\/wp\/v2\/tags?post=25921"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}