You may find health insurance at times confusing and overwhelming. There may be terms on your medical bills that you may not understand, such as “deductible” and “co-insurance”. You may wonder- “Why is my bill different this month compared to last month?” or “Why is my insurance not covering my supplies the same as before?”
These are frequently asked questions from our patients during this time of the year. We have found that the root of the answer to these questions is to have an understanding of what deductible means and how it works.
What is a deductible?
Your deductible is the total amount you will need to pay before your insurance company will start covering your medical bills- excluding copays, coinsurance, and any non-covered expenses. This amount varies per insurance plan, and may range anywhere from $0 – $10,000. An important detail to know about deductibles is that the amount resets and may change at the beginning of every year.
Most insurance plans follow a calendar year that runs from January to December.
Why is my insurance not covering my medical supplies?
Although you may feel like your insurance is not covering your medical supplies, it is applying the same amount you paid towards your yearly deductible.
For example: Ana has a $500 deductible with “X” insurance company and needs an order of medical supplies this month (January). Following Ana’s insurance contract the allowed amount for supplies is $100. This is the amount Ana will have to pay for supplies and the same amount her insurance company will apply towards her plan deductible once the claim has been processed. Once the claim is processed, Ana’s remaining deductible for the year is $400.
To learn more about your plans’ benefit coverage refer to your health plan or contact your insurance carrier for more information.