Florida Coinsurance Tricks

Florida Coinsurance Guide

A Rip-off Scam To Be Wary Of

Health Insurance


Health insurance in Florida is a little like health insurance in the rest of the country, only with many more shenanigans. This is why we offer the guide to shopping for health insurance in Florida. The singularly most important thing to watch for is your out of pocket annual maximum. In many cases, this is the most prime area for companies and health agents to pull a fast one. The agents will typically show you a deductible which is somewhat low and then they stop there and will not even discuss coinsurance which comes after the deductible and is really a continuation of the deductible.

Coinsurance defined is the percentage after the deductible that the insured is responsible for. So if the coinsurance is 80/20 the insured would first meet the deductible and then continue to be responsible for 20% of the bills. With most reputable health insurance companies in Florida like Blue Cross or Aetna the coinsurance would stop at a defined amount, with Aetna the average is two thousand dollars. Hence, when calculating your annual exposure, it is important to add the deductible and the coinsurance maximum.


The Florida Companies that Practice the Art of Deceptive Marketing


For example, if you were to purchase the Aetna Open Access 2500 health plan in Florida your deductible obviously would be 2500 and the coinsurance is 80/20 to 2500. This means that in the case of this particular health plan your out of pocket maximum is your deductible $2500 plus your coinsurance maximum $2500 for a total annual out of pocket maximum of $5000.

This is where the health insurance companies that are less than reputable where pull their tricks. They have either no coinsurance maximum or an extremely high coinsurance maximum so in many cases your out of pocket maximum is infinite, as you would be responsible for 20% of your medical bills in perpetuity.

So, which ones do this?  Well, anything from Health Markets will actually fall into the category of the undefined coinsurance, as their products including Mega, Midwest, and United American should be unconstitutional.  These Florida health insurance companies will actually kill you if you let them.  They are more harmful than radiation exposure.  In Miami, Preferred Medical also has a 25% coinsurance with no ceiling as well.

The other companies including Avalon and even Golden Rule to some extent, as well as lesser known names such as Assurant, who just have extremely high coinsurance maximums.  Though you don’t have to pick these options, disreputable brokers will conceal the coinsurance from you and instead let you think you are getting  a great plan and the best rate ever.