Wondering if someone here has the explanatory deets on this before I go call up my insurance company and begin that whole series of shenanigans.
I have a $500 in-network deductible. I have had over $10k in medical bills so far this year (!), for which my out of pocket cost has been $900.
Of that $900 out of pocket cost, only $80 of it has gone towards my deductible.
These are all covered services with in-network providers. Why is this not going towards my deductible? My understanding was that only uncovered services or services with out-of-network providers were not supposed to go towards the in-network deductible.
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Is much of the $900 copays? My insurance does not put copays towards the deductible
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Yeah, this is my thought too. My insurance is amazing and covers almost everything with just a normal visit or specialist copay so I almost never hit my deductible. The only we do hit deductibles is if we have surgery or an MRI. For those things we have to pay our deductible + the copay, and then once we’ve met the deductible it is just the copay.
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Some of the $900 is a straightforward copay – like a $35 charge for a specialist visit, and it makes sense (ish) that that doesn’t go towards deductible.
Some of the rest is not obviously a co-pay; it’s a portion of e.g. labs/ultrasounds that are hitting my pocketbook. I assume it’s co-insurance? which maybe they also don’t put towards the deductible?
(but also then why am I paying co-insurance before paying the deductible? I’m so confused)
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I think coinsurance should definitely go towards the deductible, so I would give a call about that! Although I know calling insurance is like the least pleasant experience on earth…
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