Understanding medical / health insurance quote?
I recently got a quote for a health insurnace, but I am not sure I have a proper understanding what they mean…
IN NETWORK:
Deductible Ind / Fam – 2500/5000
Co-Insurance – 80%
Maximum Out-Of-Pocket – 5000/10000
then some co-pays for Office, Labs, Specialists (I’m OK with that)
Hospital 2500/5000 In/Out Net
So, the QUESTION IS:
If I am taken to hospital for 10 days (say, I am Ind, not Fam; and the bill, say, is 18000):
- I first pay Deductible 2500;
- then I pay 80% of the amount up to 5000 Max Out-of-Pocket;
- and then Insurance covers the remaining part of the bill?
How it works if the Hospital part In Net looks like 500D/5D/admit after Ded – who pays if it is over 5 days and how much? 100% or Co-Insurance part?
Thank you for your help, as I got confused even after reading all the helps on insurance web-sites.
mbrcatz posted: 18 Jul at 10:32 am
You should be buying through a local agent, instead of trying to do “do it yourself” insurance – they can explain how all this works.
Your abbreviations aren’t clear – if you have a five day deductible, the first five days of care aren’t covered. If you have a limit of coverage, to five days, then YOU pay every day over five days.
Lisa posted: 18 Jul at 11:14 am
If you are going to do it yourself get quotes from different life insurance companies first. Agents will cost you $. If it is too much trouble then consider getting a non term life insurance plan for say like $50,000 without a medical exam.
MICHELLE C posted: 18 Jul at 12:11 pm
I’m not an expert on this, however I would suggest you take a tour here http://www.HealthInsuranceIdeas.info/free-online-health-insurance.htm ,there are expert’s tips there.
JamieGRL posted: 18 Jul at 12:30 pm
Is your deductible included in your out of pocket max ?
sometimes it is, sometimes it isn’t.
you pay your deductible of 2500$ …
then you pay your co-insurance of 80% up to 5000$ (oop max)
then insurance pays 100% of covered services for the calendar yr.