Question

Describe the deductible, coinsurance, and copayment requirements for an HMO plan.

Answer 1

Answer:

A deductible is the amount you pay for health care services before your health insurance begins to pay. The deductible in the HMO Plan will pay the full charges once you have reached the total deductible. You will start paying less, with a copay or coinsurance, depending on the selected plan. When the limit is reached, you share the cost with your plan by paying coinsurance.

Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, that typically applies after your deductible has been met. Let's say your health insurance plan's allowed amount for an office visit is $50 and your coinsurance is 20%. All you have to pay is the 20% and your coinsurance will pay the rest.

A health insurance copayment is a fixed amount a healthcare beneficiary pays for covered medical services. The rest of the balance is paid for by the person's insurance company. Copays for standard doctor visits are typically lower than those for specialists.