Ask a Health Professional INSICHT (715) 732-2101 3003 Cleveland Avenue Marinette, WI Andrew Congdon, O.D. Doctor of Optometry INSIGHT VISION CENTER Question: How Does My Insurance Work? You have heard The higher the deductible the lower the A: may many different terms monthly premium in the news lately From Deductibles to Max Out of Pocket This is a number Premiums, to coverage generally larger than your deductible This is the amount that you would have to pay even after a deductible is met If you have a go% to 10% plan, that i There are many words that are used when talking about insurance, and we will try to explain a basic understanding on how insurance works means that once your deductible is met, you still have to pay so9% of the charges Insurance is what you buy as a way to until you meet your max out of pocket better afford health care costs. When The higher the Max Out of Pocket, the you buy insurance, there are a few lower the monthly premium. factors that go into the price of that insurance. If your job offers insurance, Co-Pay This is a set amount that you you will be part of a group. Generally, Owe for every visit. This does not go when you are in a group your insurance towards your deductible This can vary if will cost less due to many people having youre visiting your primary care doctor the same plan which can negotiate of a specialist a discount. People who own their Co-Insurance You may have more own business, or their job does not than one insurance to cover the cost offer insurance, generally have higher of your deductible. Many people on healthcare cost. The following tems will Medicare have a second insurance to decide the cost and how the insurance help with coverage, this is often called is run. a Secondary Premium Your premium is your monthly cost of the insurance If you never use your insurance, you still have to pay a premium. The amount that you pay is greatly affected by other factors. higher the premium, the lower When an insurance Coverage company says something is covered that doesn't mean it will pay for it. What coverage means, is that the insurance company recognizes the charge, and the amount will go to your deducible. If you The the other costs tend to be. If you have multiple people on the same insurance in your family, your premium will go up The money paid to a premium doesnt go to your deductible, or max out of pocket haven't met your deductible, you have to pay the charge Coverage does not mean your insurance will pay the charge Prior Authorization your insurance will require you to ask for permission before getting certain tests or drugs covered. This can be a tedious task by your doctors office, and may take weeks to months to complete Sometimes Deductible A deductible is a set amount of money that you have to pay before insurance will start to help you with payments When you have a bill from a doctor, there will be service Insurance can be confusing The charges If you have not paid enough to biggest take away is that insurance is reach your deductible, your insurance not a guarantee for payment. If your will not help you with these charges. insurance company does not pay a Onceyou 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 if you haven't reached your max out of compamy, not the doctor's office to find pocket out why it hasn't been paid Ask a Health Professional INSICHT (715) 732-2101 3003 Cleveland Avenue Marinette, WI Andrew Congdon, O.D. Doctor of Optometry INSIGHT VISION CENTER Question: How Does My Insurance Work? You have heard The higher the deductible the lower the A: may many different terms monthly premium in the news lately From Deductibles to Max Out of Pocket This is a number Premiums, to coverage generally larger than your deductible This is the amount that you would have to pay even after a deductible is met If you have a go% to 10% plan, that i There are many words that are used when talking about insurance, and we will try to explain a basic understanding on how insurance works means that once your deductible is met, you still have to pay so9% of the charges Insurance is what you buy as a way to until you meet your max out of pocket better afford health care costs. When The higher the Max Out of Pocket, the you buy insurance, there are a few lower the monthly premium. factors that go into the price of that insurance. If your job offers insurance, Co-Pay This is a set amount that you you will be part of a group. Generally, Owe for every visit. This does not go when you are in a group your insurance towards your deductible This can vary if will cost less due to many people having youre visiting your primary care doctor the same plan which can negotiate of a specialist a discount. People who own their Co-Insurance You may have more own business, or their job does not than one insurance to cover the cost offer insurance, generally have higher of your deductible. Many people on healthcare cost. The following tems will Medicare have a second insurance to decide the cost and how the insurance help with coverage, this is often called is run. a Secondary Premium Your premium is your monthly cost of the insurance If you never use your insurance, you still have to pay a premium. The amount that you pay is greatly affected by other factors. higher the premium, the lower When an insurance Coverage company says something is covered that doesn't mean it will pay for it. What coverage means, is that the insurance company recognizes the charge, and the amount will go to your deducible. If you The the other costs tend to be. If you have multiple people on the same insurance in your family, your premium will go up The money paid to a premium doesnt go to your deductible, or max out of pocket haven't met your deductible, you have to pay the charge Coverage does not mean your insurance will pay the charge Prior Authorization your insurance will require you to ask for permission before getting certain tests or drugs covered. This can be a tedious task by your doctors office, and may take weeks to months to complete Sometimes Deductible A deductible is a set amount of money that you have to pay before insurance will start to help you with payments When you have a bill from a doctor, there will be service Insurance can be confusing The charges If you have not paid enough to biggest take away is that insurance is reach your deductible, your insurance not a guarantee for payment. If your will not help you with these charges. insurance company does not pay a Onceyou 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 if you haven't reached your max out of compamy, not the doctor's office to find pocket out why it hasn't been paid