Say my deductible is 1500 and I need a procedure that’s costs $1000 but my insurance will cover 50% before deductible. A few months before the procedure I managed to meet my deductible though does that mean they will cover 100% of it or the 50% still?

If possible try to explain like I’m five

  • GlendatheGayWitch@lemmy.world
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    2 months ago

    If you’ve met your deductible, you may not owe for the upcoming procedure.

    However, you’d need to look at your policy or call the insurance company to see if the procedure counts towards your deductible. Normally the plan specifies that its 50% before the deductible and by an asterisk or buried somewhere in your plan’s terms, it may say that it’ll be 100% covered after tour deductible is met.

    Is your deductible and out-of-pocket max the same? If you’ve met both, you may not even owe a copay. If you still haven’t met the out-of-pocket max, you will still owe co-pays.

    Your plan documents or the company will be able to give better answers, as companies and plans can be very different in how they cover things.