roughedges
Karma: 0
Answers: 1
what is the difference between co-pay and co-insurance?
Answers: 2
Views: 407
Rating: 0
Posted: 13 years ago
nope.
Copay is a charge you are responsible for - for every visit. So if you have a $20 copay for an office visit. You pay the doc's office $20 every time you go to the doc. (if you go twice in one day there is usually no charge for the 2nd visit.) but you owe this regardless of what your insurance pays.
so the doc billy the insurance
next thing is the insurance co looks at the claim and makes sure everything is covered. As an example - cosmetic surgery is almost never covered - they would deny this - whatever they do cover is the "allowed amount"
then the insurance company applies what ever discount they have negotiated with the doc. This is why it is important to use the docs the insurance company has contracted with.
what's left is the benefit amount - this is the amount the contracted doc will accept as full payment
finally the insurance company applies "co-insurance" - it splits the cost up into what they pay and what you pay. So with 80% co insurance - on a $1,000 benefit amount - they pay $800 and you pay $200.
What 6dog was refering to is called "coordination of benefits" - even more complicated...
Rating: 0
Posted: 13 years ago
Top Contributors
Answered Questions
mu888zcom
Answers: 8
Views: 63
Rating: 0
hitclubporn2
Answers: 13
Views: 88
Rating: 0
TK88
Answers: 13
Views: 120
Rating: 0
go99broker
Answers: 12
Views: 105
Rating: 0
WHY ISO 45001 PERU?
Answers: 10
Views: 129
Rating: 0
RAKHOITV - Thế giới cá cược đỉnh cao, cơ hội thắng lớn mỗi ngày!
Answers: 23
Views: 195
Rating: 0
Jun88
Answers: 16
Views: 186
Rating: 0
OKVIP Đồng Hành Cùng Giải Ngoại Hạng Anh Premier League
> More questions...
Answers: 11
Views: 143
Rating: 0