So this arrived in email:
"Higher coinsurance rates correspond to higher annual limits on medical out-of-pocket costs"
Okay, I'll bite; after all, most non-HDHP (hight deductible health plans, like HSA's) have some cost-sharing (aka co-insurance), and 80/20 is pretty standard.
But what, exactly, does 80/20 mean?
Well, you won't learn the correct answer from the rocket surgeons at HealthPocket:
"A new analysis of coinsurance rates from HealthPocket, Inc., shows that the average coinsurance rate nationally for individual and family health plans is 20 percent, meaning that people with coinsurance are paying one-fifth of the costs on average for certain more expensive services such as hospitalization, child birth, emergency care, and others."
First, I would question their use of the term "average," which implies that lots of folks have plans with 70/30 or 90/10 (or even 60/40) levels. They most likely mean "typical." But that's far from their most egregious error. Look again at that sentence, and especially this:
"people with coinsurance are paying one-fifth of the costs"
Um, no, HP, that's not how co-insurance works. If you'd simply read your own policy, you'd see that, once the deductible is met, you're responsible for 20% of the next "x" number of dollars, after which the plan steps up from 80% reimbursement to 100% (of covered expenses, of course). That's why the next section of your little booklet tells you your "out-of-pocket maximum" for covered expenses. These will be higher if you choose out-of-network providers, of course.
And co-insurance doesn't just apply to "more expensive services," can also apply to lower cost items if you're in that co-insurance "corridor." All you really had to do was ask your agent to explain it to you before you fired off an email that just makes you look, well, stupid.
Better luck next time.
"Higher coinsurance rates correspond to higher annual limits on medical out-of-pocket costs"
Okay, I'll bite; after all, most non-HDHP (hight deductible health plans, like HSA's) have some cost-sharing (aka co-insurance), and 80/20 is pretty standard.
But what, exactly, does 80/20 mean?
Well, you won't learn the correct answer from the rocket surgeons at HealthPocket:
"A new analysis of coinsurance rates from HealthPocket, Inc., shows that the average coinsurance rate nationally for individual and family health plans is 20 percent, meaning that people with coinsurance are paying one-fifth of the costs on average for certain more expensive services such as hospitalization, child birth, emergency care, and others."
First, I would question their use of the term "average," which implies that lots of folks have plans with 70/30 or 90/10 (or even 60/40) levels. They most likely mean "typical." But that's far from their most egregious error. Look again at that sentence, and especially this:
"people with coinsurance are paying one-fifth of the costs"
Um, no, HP, that's not how co-insurance works. If you'd simply read your own policy, you'd see that, once the deductible is met, you're responsible for 20% of the next "x" number of dollars, after which the plan steps up from 80% reimbursement to 100% (of covered expenses, of course). That's why the next section of your little booklet tells you your "out-of-pocket maximum" for covered expenses. These will be higher if you choose out-of-network providers, of course.
And co-insurance doesn't just apply to "more expensive services," can also apply to lower cost items if you're in that co-insurance "corridor." All you really had to do was ask your agent to explain it to you before you fired off an email that just makes you look, well, stupid.
Better luck next time.
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