Dr. Copay in California: Understanding Health Insurance in the Golden State
Health insurance is a very necessary monthly expense – without an insurance plan, a single medical event has the ability to bankrupt your family. Even worse, you may have trouble finding a doctor who will see you for even basic treatment. When you’re out searching for a health plan, there are some basic factors that you need to take into account.
Copays
The copay is the amount of money you must pay each time you visit a doctor. Some plans may allow you to visit a doctor for one or two visits per year with no copay, and then institute one for all following visits. Some plans have a copay for all doctor visits. A copay may be a flat fee of $20 or more, or a percentage of the visit. In either case, this cost can really add up if you have frequent visits. Find out the doctor copay amount before you sign up for any health insurance plan. Getting family health insurance in California can save you a lot of money on regular doctor visits alone if you go a lot.
Hospital Costs
Hospital costs can be astronomical. For even a single procedure or night in the hospital, you may end up with a bill of thousands of dollars. This is what makes it so important to consider hospital coverage when you choose a health insurance policy. Find out about charges per day or admission, and what percentage of your basic hospital care is covered. Your plan may pay out only after a deductible is met, or it may begin to cover hospital expenses from the start of the year before you pay against the deducible.
Maximum Out of Pocket
The maximum out of pocket amount, or OOP, is the most money you will have to pay per year. In the event of a catastrophe or major surgery, you won’t have to pay out any expenses after you meet this amount. Keep in mind that this only applies to the calendar or fiscal year that your plan operates on, so once the new year starts you will have to meet the maximum out of pocket again before your insurance pays 100% of your costs again.
Prescription Coverage
Prescription coverage is not standard on every health insurance plan. If it is offered, you may not be covered for the same amount on generic drugs as you are on name brand prescriptions. The deductible and amount covered for prescription drugs is tracked separately from your other expenses, so the maximum out of pocket paid for other procedures and visits won’t apply to your prescription coverage. If you take at least one medication on a regular basis, make sure it’s covered under a medical plan before you sign up for that plan.
Medical coverage can be a life saver in literally terms, and it can also prevent you from going into major medical debt. Always assess each potential health care policy carefully before you sign on the dotted line, and make sure the procedures you are most likely to need will not be excluded from coverage.
Melissa Rudd is a former insurance underwriter. Now retired, she likes to relax by blogging online.
Category: Medical Insurance
