Insurance plans generally have deductibles, co-pays, and/or coinsurances.
- A deductible is an annual expense that you must pay before your insurance benefits can begin. This amount can vary based on place of service (i.e. your doctor’s office vs. a large hospital). Supplemental insurance plans may cover this cost.
- Coinsurance is the portion of the total bill (usually a percentage) that is the patient’s (or guarantor’s) responsibility to pay. This amount can vary based on place of service (i.e. your doctor’s office vs. a large hospital). Supplemental insurance plans may cover this cost.
- A co-pay is a set amount paid each visit, based on your insurance policy. This usually does not count toward your deductible.
Example: On a $500 bill, your deductible might be $150, so you would have to pay the first $150. This leaves a balance of $350. Of that $350, your co-insurance might be 20 percent, meaning that you will have to pay an additional $70. Your insurance company should pay the remaining $280. The hospital will file this claim for you. After insurance has been billed, you may receive a bill on any remaining balances.