post Category: Health Insurance post postFebruary 2, 2008

Don’t get “Co-Payment” and “Co-Insurance” confused. Remember, “Co-Insurance” is a percentage (20%) of approved medical expenses that you pay and there is a limit (maximum out-of-pocket). A “Co-Payment” is completely different.

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In Health Insurance A “Co-Payment” Is Not “Co-Insurance - Know The Difference.

If you take any prescription medications, you already know how a “Co-Payment” works - you may pay $10.00 for generic drugs and $20.00 for named brand drugs (whatever your health insurance policy requires).

Some health insurance policies are designed to require a “Co-Payment” for almost everything, like:

  • Each Hospital Admission - $ 500.00 Co-Payment
  • Outpatient Surgery - $ 250.00 Co-Payment
  • Emergency Room - $ 100.00 Co-Payment
  • Doctor Visit - $ 20.00 Co-Payment
  • Specialist Visit - $ 40.00 Co-Payment
  • Generic Prescription Drugs - $ 10.00 Co-Payment
  • Name Brand Prescription Drugs - $ 20.00 Co-Payment

Other health insurance plans may have the “Co-Payments” for doctor visits and prescription drugs and use the “Deductible” and “Co-Insurance” arrangement on all other approved medical expenses.

If your health insurance plan requires “Co-Payments”, these payments must be made each time that particular medical service is required. Remember, “Co-Payments” do not reduce your maximum out-of-pocket expenses.

IMPORTANT: If you are currently shopping for the right health insurance plan and comparing health plan prices, please make sure all the benefits, deductibles, exclusions, co-payments and lifetime maximums are the same. Never cancel an existing health insurance policy until the new health policy has been issued and is in full benefit.

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