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Posts Tagged ‘coinsurance’
Saturday, June 4th, 2011
Many people are confused about the differences between what is an insurance deductible, co-pay and coinsurance. All three represent the portion of the medical bill that you are responsible for in case you get sick or injured. However, there are some differences:
Deductible: A deductible is usually a fix dollar amount that you have to pay out of your own pocket before the insurance will cover the remaining eligible expenses.
Depending on the insurance plan, the deductible can range from $0 all the way up to thousands of dollars. It can also be paid per sickness/injury (per condition) or per certificate period.
As a rule of thumb, the higher the deductible the lower the premium (price to buy the plan) would be and vice versa. Be sure to choose the deductible that is appropriate for your circumstances when purchasing an insurance policy.
Coinsurance: A coinsurance is usually a percentage that the insurance will pay toward your eligible medical expenses. Some common coinsurance includes: 100%, 80/20, 90/10 and 50/50. As an example if you have a 80/20 coinsurance, it means that the insurance company will cover 80% of your medical cost and you are responsible for paying the other 20% yourself.
A deductible is commonly use together with a coinsurance. In this case you would pay the deductible amount first and after you would have the left over coinsurance amount.
Copay (copayment): Copays are similar to deductible, it is usually a fix amount of money you have to pay each time you need to use the insurance. A copay is usually small amount that you pay which applies to certain benefits like general doctor visit or prescription medication.
An insurance policy may have a deductible, coinsurance, copay, any combination of the three or none at all.
Tags: coinsurance, copay vs coinsurance, deductible vs coinsurance, deductible vs copay, health insurance explain, insurance copay, insurance deductible, insurance out of pocket expense, study abroad insurance, Travel Insurance Posted in Insurance Explained, Product Information, Student Insurance, Travel Insurance | No Comments »
Friday, December 5th, 2008
Insurance benefits and terms can be tricky to understand at first even to seasoned insurance buyers. However, it’s important to understand fully what your policy covers and doesn’t cover. If you don’t, you may be caught in a situation where your policy doesn’t cover it and you may have a high medical bill to pay all yourself.
Let’s take for example, maternity benefits. These benefits will vary in most insurance policies you look at. Some policies may cover it after a 12 month waiting period, some may cover it right away and others might not cover it at all. You also want to make sure how much it covers and what the actual limit it is covered up to. For instance, the Citizen Secure policy offers maternity benefits after 12 month of continuous coverage. Covered maternity benefits include pre-natal, delivery and post-natal care. The insurance company will pay 50% of the next $100,000 worth of eligible expenses after the deductible, then 100% to a lifetime maximum of $250,000. On this policy the deductible is per certificate period and you must meet it before the insurance company will pay towards your eligible expenses. You will also have coinsurance if you choose not to go within the PPO. If you choose to go within the PPO, then you would have 0% coinsurance.
Maternity benefits for the Student Secure policy are quite different. If you are not pregnant before the policy is effective, then you receive full maternity benefits from the first day your policy starts. Covered maternity benefits include but are not limited to pre-natal, delivery and post-natal care as well as expenses for miscarriage and complications of pregnancy. Like all benefits on this policy, maternity benefits are first subject to the deductible and coinsurance. The deductible for this policy is $100 per injury or illness. Coinsurance is dependent upon which level you purchase. On the budget level, the insurance company will pay 80% of the next $10,000 worth of eligible expenses (after the deductible), then 100% to the overall limit ($250,000). On the select level, the insurance company will pay 100% of eligible expenses (after the deductible) up to the overall limit ($300,000) if you go within the PPO or to the student health center.
Finally, the Atlas Travel series policy does not offer maternity benefits. However, if you are already pregnant then this may be the only option we offer. The Atlas series does offer coverage for complications of pregnancy up to the 26th week. This is defined as illnesses whose diagnoses are distinct from pregnancy, but are adversely affected by pregnancy or cause by pregnancy, and not associated with a normal pregnancy. Like the other two plans, benefits are subject to the deductible and coinsurance. With this policy, you have the freedom to choose your deductible (ranging from $0 up to $2,500) and your policy limit (from $50,000 up to $1,000,000). Coinsurance is 100% of eligible expenses while outside the U.S. and inside the U.S. (if you go within the PPO).
Tags: atlas insurance, citizen secure, coinsurance, deductible, insurance terms, maternity, PPO, pregancy Posted in Insurance Explained, Product Information, Student Insurance | No Comments »
Wednesday, August 22nd, 2007
This is one of the most popular questions we receive. The Student Secure plan, which is particularly designed for F1 visa holders or full-time international and study abroad students, has two levels: budget and select. The budget level provides up to $250,000 worth of coverage and the select level provides up to $300,000 worth of coverage. The select level also provides coverage for accidental death & dismemberment and the budget level does not. However, these are not the only differences. The main difference is in the coinsurance.
Coinsurance is a percentage that you have to pay after you meet the deductible. The deductible is usually a fixed amount. For both levels, the deductible is $100 per injury or illness. For the budget level, your coinsurance portion would be 20% of the first $10,000 of eligible expenses. Then, the insurance company will pay 100% of your eligible expenses up to the certificate period maximum. So, for example, you incurred $5,000 worth of eligible expenses. You would be responsible for the deductible ($100) plus the 20% coinsurance. So, your total would be approximately $1,100. If you chose the select level, then your coinsurance is waived if you go to the Student Health Center or if you go to a doctor within the PPO (network of doctors). So, in the example above you would only be responsible for the deductible ($100). The select level may be more expensive when you choose to purchase the Student Secure plan, however, it greatly reduces your out-of-pocket expenses.
To further explain what a deductible is, the deductible is the amount that you are required to pay before the insurance company will pay toward your eligible expenses. For the Student Secure plan, the deductible is $100 per injury or illness. This means that you would pay the first $100 plus any coinsurance applicable (if you chose the select level and went within the PPO or to the Student Health Center you would not be responsible for the coinsurance) per injury or illness. This deductible is not per visit. If you became ill or injured and you went to the doctor you would pay the deductible plus any coinsurance applicable. If you needed to go back for a follow-up visit you would not need to pay the deductible again. You would simply pay the applicable coinsurance portion.
If you should have any further questions, please e-mail us at info@InternationalStudentInsurance.com or call us at 1-888-247-1387.
To view all the benefits, quote or apply online click here: http://www.internationalstudentinsurance.com/student_secure_international/
Tags: coinsurance, deductible, international student insurance, student secure plan Posted in Insurance Explained, International Student in the USA, Product Information, Student Insurance | No Comments »
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