INSURANCE TERMS EXPLAINED: A QUICK PRIMER
One thing we do at Reddy Care Physical, Occupational, & Aquatic Therapy is help you make the most of your health insurance plan. We know how confusing they can be and want to ensure you get the care you need (for as little money as possible). We’ve found that many people struggle with common insurance terminology, so here’s a quick primer: • Copay: Also known as a copayment, this refers to the amount of money you may have to pay before receiving a medical service (such as seeing a physician). • Deductible: A deductible is a fixed amount of money you’ll need to pay out of pocket before insurance will cover your medical expenses. It generally resets each year. • Coinsurance: Coinsurance refers to the cost you split between your insurance provider, often after you’ve met your deductible.
WHAT THESE TERMS MEAN IN PRACTICE Mary’s insurance plan has a deductible of $1500, 80/20 coinsurance, and a doctor’s copay of $10. • Any time Mary visits her doctor, regardless of whether or not her deductible has been met, she pays $10. • However, she has to pay for other services 100% out-of-pocket until the costs accrue to $1500. • At that point, any additional services are split between Mary and her insurance: she pays 20% of costs, and they pay 80%. • When the new year rolls over, Mary’s deductible resets. We know it can be confusing. If you have any questions about how your insurance impacts your access to physical therapy, we’re here to help!
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NEW YORK CITY
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