Cable Forum - View Single Post - Millions to be affected by NHS plan to ration 34 everyday tests and treatments

**Hugh** · 03-12-2019, 18:20

Quote:

Originally Posted by jfman

The average health insurance premium in the USA is $321 a month for individual coverage.

And that doesn’t include co-pay and deductibles...

https://www.verywellhealth.com/deduc...erence-1738550

Quote:

Deductibles
A deductible is a fixed amount you pay each year before your health insurance kicks in fully. Once you’ve paid your deductible, your health plan begins to pick up its share of your health care bills. Here’s how it works.

Let's say your plan has a $2,000 deductible and counts all non-preventive services towards the deductible until it's met. You get the flu in January and see your doctor. After your health plan's negotiated discount, the doctor’s bill is $200. You are responsible for the entire bill since you haven’t paid your deductible yet this year. After paying the $200 doctor’s bill, you have $1,800 left to go on your yearly deductible.

In March, you fall and break your arm. The bill after your health plan's negotiated discount is $3,000. You pay $1,800 of that bill before you’ve met your yearly deductible of $2,000. Now, your health insurance kicks in and helps you pay the rest of the bill.

In April, you get your cast removed. The bill is $500. Since you’ve already met your deductible for the year, you don’t have to pay any more toward your deductible. Your health insurance pays its full share of this bill.

However, this doesn’t mean your health insurance will pay the entire bill and you won’t have to pay anything. Even though you’re done paying your deductible for the year, you may still owe a copayment or coinsurance, until you've met your plan's maximum out-of-pocket for the year (in most cases, coinsurance applies to services that would count towards the deductible if you hadn't already met it for the year)...

... Copayment
A copayment is a fixed amount you pay each time you get a particular type of healthcare service. Here’s how it works.

Let’s say your health insurance requires a copayment of $30 each time you see your primary care physician, $50 each time you see a specialist physician, and $20 each time you fill a generic prescription.

If you see your PCP on May 1, you pay the physician $30 that day. Your health plan picks up the rest of the bill for that visit. When you go back to your PCP on May 5, you have to pay another $30 copayment. Your health plan pays the rest of that bill, too.

Your PCP sends you to a specialist. When you see the specialist on May 12, you pay a $50 copayment to the specialist. Your health insurance pays the remainder of the specialist’s bill.

So if you have a $2,000 deductible in addition to various copays to see your primary care doctor or specialist or have a prescription filled, you'd have to meet your deductible for treatments other than those covered by copays.