Copay after deductible

Question-

I have only ever had deductible + coinsurance plans, and we are considering switching to my husband's plan next year since we are having another baby and the provider we want is in network with his and not mine.

His plan is a $2,500 embedded deductible ($5,000 total family deductible, embedded OOP max of $6750 pp/$10000 family) then copay after deductible

How my deductible + coinsurance worked before was deductible + % of every dollar over the deductible

My question is – how does that work with a deductible before copay plan if the charge is higher than the deductible initially?

Example: embedded deductible is $2,500 and copay for that type of service after deductible is $150…. if the original charge for the service is $6000, how would that be costed? Would we pay the $2,500 plus the $150, or still just pay the full $6000?

Thanks! I hope this makes sense the way I asked.

ETA: This is in NY

submitted by /u/MidstFearNFaith
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