Out of Pocket Costs for Health Insurance Policy Arizona AZ
Reader’s Question:
I was told I’d still have to shell out some cash if I needed some kind of medical attention. Can you explain to me the how out-of-pocket costs are determined? This is Berny from Arizona.
Berny
Glendale, AZ
You’re right. Even though you have pretty broad health insurance coverage, some of the expenses will have to come from you. First of all, you’ll have to pay for the deductible. The lower the premium of your health insurance policy is, the greater the deductible. So this one really depends on how much you have agreed to pay as deductible.
Second, there are certain cost-sharing amounts that you take out of your own pocket. Health insurance policies have a “coinsurance clause,” which states that you must share the cost of your medical bills. For example, if you have a 90/10 coinsurance arrangement, you must pay ten percent of your medical expense. It comes in different proportions such as 80/20 or 70/30. This should have been explained to you when you purchased your health insurance policy there in Arizona.
Finally, if you opt to hire the services of a top physician who charges you a whole lot, or you go through an expensive medical or surgical procedure, you might also end up shelling out more. Health insurance companies set “customary” charges for certain medical procedures. This is the amount they consider reasonable. If they find that you were charged unreasonably high rates by a health provider, they may choose to cover only a certain percentage of it.
Tags: Health Care, health insurance
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