How to read your medical bill

You are finally enrolled in an insurance plan. The premiums are paid and a brand new card arrives in the mail. But unfortunately you will still get some medical bills in the mail. Before you franticly call up your doctor’s office and give the secretary a 15 minute long yelling there might be some information you are missing.

What is a deductible?

A deductible is the initial amount you must pay every year before the insurance pitches in. In other words nothing is covered before the deductible is paid. Its important to note that the more expensive the premiums are the cheaper the deductible is.

OK the deductible is paid in full, but the bills are still coming, now what?

What is a copayment and coinsurance?

After the deductible is paid, there is a small payment and the insurance covers the rest. A copayment is a set dollar amount, for example $25 for every doctors visit. A coinsurance is a fixed percentage, rather than a flat amount, for ex 10% of the doctor’s visit.

So if I’m footing all the bills why get health insurance?

The answer is, you are not. That where Maximum out of pocket comes in. The MOOP is a set amount that the insured pays in total, besides for the premium of course. It’s a combines the deductible and copays/coinsurance and then the insurance covers Everything.

Hope you won’t have to pay your deductible, but if you do at least you know there is someone behind you that will pick up the large claims.