Health Insurance Coverage

Discussion in 'Community Discussion' started by ayeying, Jul 1, 2012.

  1. ayeying
    Expand Collapse
    macrumors 601


    Dec 5, 2007
    Yay Area, CA
    So, I landed a new job. Great pay, easy work. All's good, except now I'm looking at selecting for the company covered health plans.

    So the plan is as follows:

    $1500 Deductible
    20% Coinsurance
    $5000 Payment Limit

    It's a PPO based plan. From what I've read, the deductible is the maximum amount that I pay, then it turns into Co-Pay.

    However, they also mentioned about having Copay instead of using deductible with In-Network doctors?

    I'm not exactly sure what I'm looking at right now.

    What I want, is to choose a doctor, don't exactly have a preference, whatever's in network is fine with me. But during doctor visits, only pay a Co-Pay not the full charge of services provided. Is this something not provided by PPOs?
  2. miles01110
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    macrumors Core


    Jul 24, 2006
    The Ivory Tower (I'm not coming down)
    If a plan is considered a "PPO" it just means that there's a network of doctors/health care providers that have agreed to take part in whatever plans the insurer offers. The plan you describe might fit with what you want; a plan with only a copay and no deductible would probably be more expensive. If there's a clause in there that says the deductible only applies to out-of-network providers you probably just pay the copay; you'd have to give some more details before anyone can tell you for sure if that's what it says.

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