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by DJ Butter jetpacking up up and away on April 18th, 2008

DJ Butter jetpacking up up and away

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Can someone please explain how health insurance works? Deductables/co-pays/choosing a plan? I am so confused! I live in Ohio...can anyone recommend a good and affordable health insurance company?

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  • by Anonymous on April 11th, 2009

    Anonymous

    I have worked for physicians and ins companies for 16 years now and the best info I can give you is to do a lot of research. It's not a matter of which insurace company you pick, but the plan that you pick. You need to make sure that you are comparing apples to apples though. Copays = a set amount that you will have to pay for a service-example-office visit copay is $25. The deductible is accesses for pretty much anything you have done that does not take place in a doc's office such as lab tests, MRIs, CT scans eemergency room visits, inpatient stays. If you have a $5000 deduct then it means that you have to pay the first $5000 of eligible charges before your insurance will start paying anything and then usually they only pay 80% of the rest off the visit and you pay your deduct PLUS 20% of what's left. All plans have an out of pocket max and this is the maximum amt you would have to pay in a calendar year for medical services (not including copays)

    Basically it's like any other insurance, it's a gamble. If you are normally very healthy and see a doctor once a year or so, you might want to risk going with a high deductible plan, but iff you know you need services, you want a low deduct plan, or an HMO that only has copays. There's so much more to it. I hope this helps a little

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