When I go to the doctor, how much do I have to pay?
Your doctor's charge will be determined by your appointment and the advantages of your insurance plan. Some benefits need a copay (a set financial fee), while others require coinsurance (a fixed percentage amount). Insurance Made Eazy will cover the rest of your visit's costs if you pay a copay or coinsurance. You should check to see if your health plan includes an annual deductible, which is the amount you pay for treatments before coinsurance and your health plan kick in. A high deductible may have an impact on the cost of each doctor's appointment.
Most plans offer an annual out-of-pocket maximum to safeguard you and your family from unexpected costs. Once you reach the out-of-pocket maximum, your health plan will cover 100% of the most covered medical treatments up to the authorized expenses.
Charges that are permitted
The amount that Insurance Made Eazy has agreed to pay for a service or benefit. If your doctor's costs are higher than what your health insurance policy allows, you may be responsible for the difference.
A health plan with a primary care physician (PCP) who serves you regularly. Preventive checkups and referrals to specialists are included. Only other doctors or specialists in your PCP's medical group will be allowed to see you. Benefits received from doctors who are not in your PCP's network are not covered.
Insurance Made Eazy covers medically necessary treatments and supplies.
The amount due for most benefits each calendar year before Insurance Made Eazy begins to pay. Some benefits, such as preventive care, are covered before your deductible is met.
After you've reached your deductible, you're usually responsible for a certain proportion of the cost of your benefits.
Each year, the total deductible, copayment, and coinsurance amounts are the most you'll have to pay for all of the covered services.
A consortium of providers, including hospitals, doctors, specialists, and other healthcare providers, has agreed to provide benefits for a set cost to Insurance Made Eazy.
A health plan in which members can choose to see any PPO provider in the network without needing a referral. Non-network providers are also available for most benefits provided members are willing to pay a higher percentage of the cost.