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SVTPerformance's Chain of Restaurants
Road Side Pub
health insurance
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<blockquote data-quote="Logan2003Cobra" data-source="post: 16680325" data-attributes="member: 17851"><p>There are several items to consider when purchasing and using a health insurance plan. Out of Pocket, Out of Pocket Max, In-Network, Out of Network, Co-Insurance, Co-Pay, etc. Your larger insurance providers (UHC, Cigna, Aetna, etc.) usually have a large network with plenty of Primary Care Providers, Hospitals, & Specialists in the network. Also, the more expensive the plan (monthly premiums) the lower the deductibles, co-pays, & out of pocket maximums are.</p><p></p><p>Use the following high deductible plan as a generic example:</p><p></p><p>Deductible Amounts Individual/Family</p><p>* In-Network $5,000/$10,000</p><p>* Maximum out of Pocket In-Network $7,500/$15,000 </p><p>** Out of Network $7,500/$15,000 </p><p>** Maximum out of Pocket Out of Network $15,000/$30,000</p><p>Co-Insurance Once Deductible Met (co-pay)</p><p>* In-Network 20% Until Max Reached </p><p>** Out of Network 50% Until Max Reached</p><p></p><p>Scenario 1</p><p>You go to your primary care physician, need tests run, need surgery, and EVERYTHING is done In-Network... your worst case max out of pocket in this situation would be $7,500.</p><p></p><p>Scenario 2</p><p>You go to your primary care physician, need tests run, need surgery, and everything is done In-Network EXCEPT the anesthesiologist who is Out of Network and their cost is $10,000... your worst case max out of pocket in this situation would be $12,500. </p><p></p><p>Note: if both In-Network and Out of Network charges and co-pays were to be maxed out, the total Out of Pocket would not be higher than $22,500.</p><p></p><p>This is where supplemental insurance (like Aflac) can help as they would simply cut you a check depending on what you have coverage for. Granted, this might only be for a couple thousand dollars but every little bit helps when you have a major accident and/or need surgery.</p></blockquote><p></p>
[QUOTE="Logan2003Cobra, post: 16680325, member: 17851"] There are several items to consider when purchasing and using a health insurance plan. Out of Pocket, Out of Pocket Max, In-Network, Out of Network, Co-Insurance, Co-Pay, etc. Your larger insurance providers (UHC, Cigna, Aetna, etc.) usually have a large network with plenty of Primary Care Providers, Hospitals, & Specialists in the network. Also, the more expensive the plan (monthly premiums) the lower the deductibles, co-pays, & out of pocket maximums are. Use the following high deductible plan as a generic example: Deductible Amounts Individual/Family * In-Network $5,000/$10,000 * Maximum out of Pocket In-Network $7,500/$15,000 ** Out of Network $7,500/$15,000 ** Maximum out of Pocket Out of Network $15,000/$30,000 Co-Insurance Once Deductible Met (co-pay) * In-Network 20% Until Max Reached ** Out of Network 50% Until Max Reached Scenario 1 You go to your primary care physician, need tests run, need surgery, and EVERYTHING is done In-Network... your worst case max out of pocket in this situation would be $7,500. Scenario 2 You go to your primary care physician, need tests run, need surgery, and everything is done In-Network EXCEPT the anesthesiologist who is Out of Network and their cost is $10,000... your worst case max out of pocket in this situation would be $12,500. Note: if both In-Network and Out of Network charges and co-pays were to be maxed out, the total Out of Pocket would not be higher than $22,500. This is where supplemental insurance (like Aflac) can help as they would simply cut you a check depending on what you have coverage for. Granted, this might only be for a couple thousand dollars but every little bit helps when you have a major accident and/or need surgery. [/QUOTE]
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SVTPerformance's Chain of Restaurants
Road Side Pub
health insurance
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