PPO deductible waived, copays, and coinsurance?
I'm trying to choose an employer insurance plan for the first time, coming from Medicaid so a lot is confusing to me. I will make a separate post about plan choices, but the most expensive PPO option says "if you visit a health care provider's office or clinic" – primary care visit to treat an injury or illness – in-network – "$20 copay per visit; deductible waived" and for specialist visits the same thing but $30, and preventive care/screening/immunization of course says "no charge; deductible waived." And "if you have a test" – Diagnostic test (x-ray, bloodwork) or imaging (CT/PET scan, MRI) it says 20% coinsurance.
These are probably dumb questions, but:
-Does this mean I'm always paying 20% of my labs/tests + my copay for the visit? Or is it ever considered part of my visit and covered by the copay??
Like if I have a cold and my PCP swabs me for COVID/flu/RSV and for strep, in her office during my visit, is it covered as part of my visit/copay? Or I'm paying $20 + 20% of my labs?? What about if I go for my appt and she orders an x-ray or a lipid panel, and I go to the in-network, on-site lab or imaging dept right away and get it done–is that the same visit?
-Also under "if you need immediate medical attention – urgent care" it says "$40 copay per visit; 20% coinsurance; deductible waived." So this means that while all the other categories have either a copay OR coinsurance after reaching your deductible, urgent care has a copay every time + coinsurance every time?
ETA I am in WI, 34, $60k gross.
submitted by /u/Particular_Radish_95
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