Question about health insurance deductibles?

[forfor]

New question: Ok, so the plan I want to go with has a $500 deductible and $2000 annual out-of-pocket maximum.

Does this mean if I go to a doctor and the total bill is $420 (with xrays for instance), I'll have to pay the full amount? They only cover after $500? Sorry, I know what deductible means but not very familiar with the American health insurance system. What about the $20 (primary) and $30 (specialist) per visit fees? What about the annual out-of-pocket maximum fees?


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Which plan did you go with? My employer has a special thing with Aetna where I pay 40%, employer pays 60% but I don't know which plan to go with? PPO 20 looks like it fits me the best but someone mentioned HMO plans? What are those? What's difference with PPO?

Anybody care to explain? Many thanks!

 

[EagleKeeper]

PPO usually has higher deductible and allows a larger range of initial primary care givers.

The HMO has higher upfront costs but lower deductibles. Limited service providers and difficult to use out of the area.

 

[forfor]

Originally posted by: EagleKeeper
PPO usually has higher deductible and allows a larger range of initial primary care givers.

The HMO has higher upfront costs but lower deductibles. Limited service providers and difficult to use out of the area.

Thanks a lot, I live in a big city and travel rarely... so you think I should get HMO?

 

[amddude]

I would get the PPO for sure, UNLESS it is just a ton more expensive. Better too much converage than too little. At my office, 100% of over 250 people have the PPO. No one has the HMO.

 

[forfor]

Originally posted by: amddude
I would get the PPO for sure, UNLESS it is just a ton more expensive. Better too much converage than too little. At my office, 100% of over 250 people have the PPO. No one has the HMO.

thanks.

bump with new question

 

[amddude]

Ok that is a more complicated question than it appears because how each company does it is varied. Basically, the deductible (this is all as I understand it) is how much you have to pay up to before they shell out, within a time period specified by them. So say, you might have a $600 bill for...breaking your leg or whatever, you have to pay $500 of that. Now, if the deductible was for the course of the year, from that point onward, you don't pay directly for anything. But, you may have a copay on drugs or procedures. From that point onward, up to 2000 you may still be paying for portions of stuff. I really need more detail to answer the question fully and accurately, however.