Help Understanding this plan’s Deductible v Copayment system
So I’m getting my first health insurance plan for myself, and I’m mixed up on how copayment / deductibles figure in with eachother in practice. I’ll give the relevant info on the plan, and some hypotheticals using their copay figures.
Likely a dumb question but gotta start somehwere and seeing other answers have made me more confused!
Massachussetts
WellSense Health Plan Clarity Silver 2000
(Individual)
Overall Deductible 2,000 Out of Pocket Max 9,450
It says clearly “Copayment after Deductible is met”
Here’s two hypotheticals using their numbers to help:
1.) Surgery:
In Network Surgery Center Fee Copay: 500 Surgeons Fees: Waived Hospital Stay: 1,000
So , from the idea I have does this mean I’d have to pay these fees (1500) on top of the deductible bringing it to a total of 3500 in this hypothetical? Or just the first 2,000? How does the out of pocket max figure in?
2.)
PCP doctor visit: 25
on the smaller scale, I doubt that means I’d have to pay 2,000 for a 25 copayment doctor visit. Or would I?
Mixed up on the order of all this – so if anyone can clear it up, and particularly help work out my hypotheticals it’d help me understand a lot. Thank you!
submitted by /u/King-Of-The-Raves
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