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DEDUCTIBLE IS NOT A DIRTY WORD
INSURANCE WAIVERS/RIDERS, RATE-UPS, & CAPPED COVERAGE
WHAT'S A “RIDER”? WHAT'S A “WAIVER”?
PRE-EXISTING CONDITIONS
WHAT'S
A “PRE-EXISTING CONDITION”?
EXCLUSIONS
WEIGHT, WEIGHT CHARTS AND HEALTH INSURANCE
AGE AND INSURANCE PREMIUM
UNDERWRITING
- WHAT IS IT?
TRIP OR HEALTH INSURANCE -- WHAT'S THE
DIFFERENCE?
AMERICAN PPOs & HMOs - WHAT'S THE
DIFFERENCE?
HIPAA / PORTABILITY INSURANCE
THE DIFFERENCE BETWEEN AN INSURANCE BROKERAGE & AGENCY
WHAT IS A “CERTIFICATE OF INSURANCE”
THE “PRE-EXISTING CONDITION” PROBLEM?
WHAT IS CO-INSURANCE?
UNDERWRITING
AT THE POINT OF APPLICATION
HOW DOES AN INSURANCE COMPANY DETERMINE
PREEXISTING CONDITIONS?
WHAT TO DO WHEN THE WEIGHT CHART SAYS YOU AREN’T TALL
ENOUGH?
WHAT IS CO-INSURANCE?
First of all co-insurance is not “co-pay.” Co-pay is the money you pay to
the doctor in the USA for an office visit. Co-insurance is not “deductible.”
The deductible is the amount of money you are required to pay for medical
expenses before the insurance kicks in and starts providing reimbursement
for medical costs.
“Co-insurance” is called “Co” because it includes a sharing of medical costs
between the client and the insurance company. Co-insurance amounts are
stated as percentages; for example, 90/10, 80/20, 70/30, 60/40, 50/50. The
most common co-insurance percentage is 80/20. What this means is that the
company will cover 80 percent of the medical expenses after the deductible,
and the client will cover 20 percent of the medical expenses after the
deductible. Almost always a cap is put on the amount that is to be covered
by the co-insurance, usually $5,000 but sometimes $10,000.
So if you have an insurance plan with a $1,000 deductible and co-insurance
at 80/20 with a cap at $5,000 in a worse case scenario you would need to pay
out $2,000. Here is how it would work: You would obviously pay your $1,000
deductible. Then you would also pay 20 percent of the next $5,000, which
would be $1,000. The insurance company would pay the other $4,000 and all
expenses beyond $5,000.
Remember as your portion of the co-insurance increases, your monthly premium
will drop. Thus a 50/50 plan will be less expensive than an 80/20 plan.
| Need Help? Call 480/813-9100; Fax 480/813-9930; Email: info@gninsurance.com |
