Question:

What out-of-pocket expenses can I expect?

Fuera de los máximos de gastos de bolsillo

Hay muchos costos asociados con la compra de planes de seguro de salud. Existen las primas que paga por la cobertura, el deducible que usted debe pagar antes de que el plan pague los beneficios, y no son los co-pagos que usted debe pagar para cubrir su parte del costo de bienes y servicios recibidos. Fuera de los gastos de bolsillo son los costos, tales como el deducible y co-pagos, que usted debe pagar a sí mismo y para los que no recibirá el reembolso de su compañía de seguros.

El máximo de gasto de bolsillo es la cantidad máxima que será responsable de pagar de su bolsillo antes que su plan comienza con las mercancías y servicios al 100 por ciento. Asumiendo que el máximo fuera de gastos de bolsillo para el año natural es de 1.500 dólares para un plan de familia que cubre a usted, su cónyuge y dos hijos, un miembro del deducible de $ 250 por familia con un máximo combinado deducible de $ 500 para todos los miembros, se han que pagar un deducible combinado de 500 dólares antes de que su plan se comenzará a pagar los beneficios.

Una vez que los beneficios comenzarán a ser pagados, usted tendría que pagar a otro combinado (es decir, para todos los miembros de la familia, no por cada miembro de la familia) $ 1.000 en co-pagos. En ese momento, se han alcanzado máximos del plan fuera del gasto de bolsillo y de todos los bienes y servicios cubiertos sería pagado en su totalidad por su plan hasta el final del año natural. Como es de esperar, las primas no cuentan para el fuera-de-gasto de bolsillo máximo.

Seguro de Salud Frequently Asked Questions

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What types of services are covered by supplemental health insurance?

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What is an Summary Plan Description?

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