There’s a certain amount you’re expected to pay per year before insurance will kick in for larger expenses. Called a deductible. And then there’s the out-of-pocket maximum, which is somehow different from a deductible. Oh, and the copay, which is the amount expected from you for routine things like checkups, therapy, and other appointments with certain in-network doctors. Out of network doctors, depending on the plan, will generally not be covered by insurance but will count towards a special out-of-network deductible amount. Unless it’s an emergency, then federal law states those expenses must count towards your normal in-network deductible.
Yes, it’s confusing. It is like that on purpose.
I’m lucky enough to be on my mom’s insurance still at 23, and because she works for our county government she has the privilege to have the option to pay for gold-standard insurance coverage. Couldn’t tell you what our deductible or out of pocket maximum is, but I can say my co-pays are generally $20 and I’ll pay anywhere from $0-$20 when I pick up a prescription depending on what coverage tier it falls under.
:)
There’s a certain amount you’re expected to pay per year before insurance will kick in for larger expenses. Called a deductible. And then there’s the out-of-pocket maximum, which is somehow different from a deductible. Oh, and the copay, which is the amount expected from you for routine things like checkups, therapy, and other appointments with certain in-network doctors. Out of network doctors, depending on the plan, will generally not be covered by insurance but will count towards a special out-of-network deductible amount. Unless it’s an emergency, then federal law states those expenses must count towards your normal in-network deductible.
Yes, it’s confusing. It is like that on purpose.
I’m lucky enough to be on my mom’s insurance still at 23, and because she works for our county government she has the privilege to have the option to pay for gold-standard insurance coverage. Couldn’t tell you what our deductible or out of pocket maximum is, but I can say my co-pays are generally $20 and I’ll pay anywhere from $0-$20 when I pick up a prescription depending on what coverage tier it falls under.