This is the section where we go over some great tips for shopping Florida health insurance, and what to do after you purchase a health insurance policy. Many of these tips include such great ideas as when to go the emergency room, as most of the Florida health insurance policies don’t cover the Emergency Room until after your deductible and by then it is often too late.
The Coinsurance Illustration
We have also devised ways to get free health insurance and to stretch out your health insurance dollars maximally.
Maternity coverage is a big question for many of our clients and prospective clients and based on our experience and the cost of these maternity health insurance policies we often advise our Florida customers to skip this coverage unless pregnancy is imminent. The cost savings of paying cash often outweigh the $110 additional health insurance premium.
How about the coinsurance situation? Most people never understand this concept and indeed I personally have fired many of our brokers after they are unable to grasp this simple concept. This is a reflection of my hiring skills coupled with the fact that I am a lousy teacher. That being said I can write well and clearly if I keep my sentence structure short.
Really quickly I am going to take a second to show you what coinsurance is:
Lets pretend that you had an emergency appendectomy and your health insurance has a $2500 deductible with 80/20 coinsurance up to to $2000. The appendectomy bill is $22,000 and that is after it was repriced because your health insurance company has negotiated with all of its providers for basic fees for most services. Additionally, you will receive a bill from the surgeon for $2000.
The first bill to come is the Surgeon’s fee, for $2000. This bill will have to be paid in full as you have not spent any money this year on your deductible and your deductible is $2500 which after this bill is considered still has $500 to be satisfied.
Now comes the hospital bill for $22,000.
You have already paid the surgeon $2000 so you have to pick up the first $500 of this $22,00 bill and you are now finished with your annual calendar year deductible. But that still leaves the 80/20 coinsurance. So because the coinsurance maxes out at $2000 you will have to pay 20% of the first $10,000. After this the health insurance company is picking up 100% of all your medical expenses for the rest of the year (except for office visit copayments and prescription copayments).
To illustrate, $22,000- $500 (deductible) = $21,500 less $2000 (because you are paying the first 20% after your deductible up until you have paid out $2000) = $19,500 which is the health insurance companies portion of the bill.