Ask a Health Professional (715) 732-2101 3003 Cleveland Avenue Marinette, WI Andrew Congdon, OD. Doctor of Optometry N SIGHT VISION CENTER Question: How Does My Insurance Work? You may have heard The higher the deductible the lower the many different tems monthly premium in the news lately Max Out of Pocket Thisis a numbe y larger than your deductible This is the amount that you would have From Deductibles, to Premiums, to coverage are many words that are used when talking about insurance, and we to pay even after a will try to explain a basic understanding you on how insurance works s me have ago% totoo plan, that s met st have to pay of% o of the ch urance is what you buy as a way to until you meet your max out of poc etter afford health care costs. When The higher the Max Out of Pocket, the u buy insurance, there are a few lower the monthly premium actors that go into the price of that rance. If your job offers insurance Co-Pay This is a set amount that you u will be part of a group Gener owe for every visit. This does not e when you are in a group, your insurance will cost less due to many people having you're visiting your primary care doctor the same plan which can negotiate ora specialst a discount. People who own therCo-Insurance You may have more ce towards your deductible This cani var offer insurance, generally have higher f healthcare cost. The following terms wl Medicare have a second insurance to decide the cost and how the insurance help with coverage, this is often or ther job does not than one insurance to cover the cost Many people on called Premium Your premium is your Coverage - W hen an insurance something is y cost of the insurance If you never use your insurance, you still have mpay says something is covered is greatly affected by other factors. company recognizes the charge, and the the other costs tend to be. If youhvehaven't met your deductible, you have to multiple people on the same insurance pay the charge Coverage does not mean The money paid to a premium doesntour insurance will pay the charge Sometimes go to your deductible, or max out of Prior Authorization before ocket Deductible A deductible is a se tests or r insurance will require you to a of money that you have to tedious task by your doctors office, and with payments When you have a my take weeks to months to complete there will be service Insurance can be confusing. The bill from a charges. If you have not paid enough to biggest take away is that insurance your deductible, your insurance not a guarantee for payment. If your will not help you with these charges. insurance company does not pay a Once you have met your deductible you bill that you thought should be paid could still be on the hook for payment you have to contact your insurance f you haven't reached your max out of company, not the doctor's office to find pocket out why it hasnt been paid