Purchasing health insurance can be very confusing. So many terms that you may not be familiar with. Some terms that you need to understand before purchasing health insurance are copays, deductibles, drug list/formulary, provider list and maximum out of pocket expense. Don Allred Insurance in Burlington, NC is there to help you to get through this confusing maze of terms and plans.
Before your insurance coverage kicks in, your deductible must be met. More than one deductible may need to be met. Drug coverage is usually a separate deductible from other services.
When you receive a service covered by your insurance the copay is the amount that you are required to pay out of pocket after you have met your deductible. It is usually defined in the paperwork you receive from your insurance company or your employer.
This is the list of covered drugs under your policy. It can include both branded and generic drugs. The amount that you will pay for each covered drug is defined by the tier it is in with Tier 1 being the lowest. Drugs can have both deductibles and copays.
This is the list of providers who take your particular insurance. Make sure that the doctors and hospitals that you prefer are on the list.
Maximum out of pocket expense
This term defines the most amount of money that you will need to spend in a year to get to 100% insurance coverage. The lower the amount is, the better for you. The HHS (Department of Health and Human Services) has proposed a maximum of $8200 per person for 2020 and $16,400 per family.
Health insurance coverage is important and making the correct decision is even more so. In Burlington, NC, Don Allred Insurance will be happy to assist you in this decision. Check out their website or call their office to set up an appointment.