How To Know If Your Completely Covered
In the United States, Americans are well aware of the cost of health care. This is because although, the economy continues to fall, health care costs continue to rise. This disturbing fact has people all throughout the United States bringing a magnifying glass to their certificate of insurance that they received from their health insurance company. Unfortunately, no matter how hard consumers look at their certificate of insurance, they may still be a little unaware of how much of their medical care is covered. With that said, I feel it is important to go over some of the terms that will be used in the certificate of insurance that people will be reading.
First off, let’s talk about coinsurance. Coinsurance is a term that is frequently used by insurance carriers but commonly misconceived consumers as a deductible. Coinsurance is the term used for the percentage of medical related expenses that Americans will be held liable for after the deductible for the policy is met. In most cases, coinsurance is stated as a percentage. For this example, we will say that a American has a policy with a $5,000.00 deductible with an 80/20 coinsurance. This means that if this consumer has a catastrophic medical issue, the person would be required to pay 20% of medical expenses once the deductible is met. Let’s put this into perspective. Let’s say that this consumer unfortunately was suddenly diagnosed with cancer and required $200,000.00 worth of medical care. In this case, the American would need to satisfy the $5,000.00 deductible bringing the total price down to $195,000.00. This consumer would still need to pay 20% of the price which would be $39,000.00. That’s quite a bit of money!
Although coinsurance may be a taboo subject when it comes to medical insurance plans, there is a silver lining to this dark cloud. With the majority of health insurance plans, there is something called a coinsurance maximum. This is the maximum amount of money that a American will be required to pay for medical care once the deductible is satisfied. With most medical insurance plans, coinsurance maximums can be decided upon at the point of sale. This means that when consumers are in the process of purchasing medical insurance plans, they have the opportunity to tell the agent what they are willing to pay for their medical care. By telling the health insurance agent what you are willing to pay, that agent will then find a policy that will meet your needs with what is called a stop loss. The stop loss will be the maximum amount of money that consumers will be required to pay for medical care expenses including the deductible and the coinsurance maximum for the health insurance plan.
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