July 21, 2022
Nova’s Latest Podcast Clarifies Health Plan Expenses
Episode Explains Deductible, Copay, Coinsurance and Out-of-Pocket Maximum
Do you pay a deductible, copays or coinsurance under your health plan? Not quite sure what each of those terms means? You’re not alone. Nova’s latest podcast episode, “Deductible, Copay, Coinsurance and Out-of-Pocket Maximums – 50 Shades of Health Insurance Grey” helps dissect the health plan math involved with your medical expenses.
In short, a deductible is the amount a member must spend out-of-pocket prior to the insurance plan covering a portion of the expenses for a medical service. After the deductible is met, then coinsurance is the portion of the benefit expense the member is responsible for (e.g.: 20 percent for a service). Meanwhile, a copay is a flat fee for service (e.g.: $25 for specialist visits). Your out-of-pocket maximum is always more than your deductible and is inclusive of all health plan spend (copays, deductibles, and coinsurance). Still a little confused? Todd Martin, Nova’s chief sales officer, joins this episode of “Under the Coverage,” to explain these different costs much more eloquently and thoroughly.
“So, there’s really two types of deductibles and two types of products,” notes Martin. “Once somebody hits their deductible, the majority of the time, the benefits will then switch over to either copays or coinsurance and a lot of them have a hybrid of both.”
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Under the Coverage features people who spend their working days focused on health benefits and health care, sharing their insider tips on information they wish every health care consumer knew. Have an idea for a future episode or a question you’d like answered? Find Under the Coverage on Twitter @UndrTheCoverage or email email@example.com.