Health Insurance: What is the Difference between a Co-Pay and Deductibles?

No matter where you live, even in Fords, NJ, health insurance is complicated. How do you decide which coverage you should select when it is time for open enrollment? Your friends at Five Star Insurance Agency are here to help you make an informed decision that will protect you and your family all year long.

Your Co-Pay Gets You in the Door for Treatment

When reviewing what benefits are included in your health insurance, you may see a list of co-pays. This means that if you have a doctor’s appointment for a physical, you will pay the appropriate co-pay when you arrive at the office. The doctor will see you and give you an exam. The same applies to an ER visit–you pay the co-pay at the registration desk, and it ensures that a doctor will evaluate and treat you. However, it may not be the only cost associated with your visit.

Your Deductible or Out-of-Pocket Expenses are Part of Additional Fees

Once your visit is completed, the doctor’s office or hospital submits a bill to the insurance company for all the procedures done during the visit. Some procedures may be included with your insurance, while others may only be covered 80%, 50%, or not at all. You will receive a bill for the remainder and that becomes part of your deductible.

Most plans have a set deductible limit like $2,000 or $5,000. Once you have paid for other procedures, services, and supplies that are not covered by the co-pay and total more than your deductible limit, your health insurance will begin to pay 100% of some of those other fees.

This article may have answered one question, but you probably now have others about how to choose the right health insurance for this year. Five Star Insurance Agency serves the greater Fords, NJ area and we look forward to assisting you in this often confusing decision. Give us a call!