Patient Out-Of-Pocket Cost Estimate
2 STEPS TO ESTIMATE THE COST
STEP 2 - CHOOSE YOUR SERVICE
2 STEPS TO ESTIMATE THE COST
- Select Category
- Inpatient Cardiology
- Inpatient Gynecology
- Inpatient Medicine
- Inpatient Pulmonology
- Inpatient Room and Board Daily
- Inpatient Urology
- Outpatient Emergency Department
- Outpatient Laboratory and Pathology
- Outpatient Medicine
- Outpatient Observation
- Outpatient Occupational Therapy
- Outpatient Other
- Outpatient Pharmacy and Drug Administration
- Outpatient Physical Therapy
- Outpatient Pulmonary Therapy
- Outpatient Respiratory Therapy
- Outpatient Speech Therapy
- Outpatient Supplies
- Outpatient Surgical Services
- Outpatient X-Ray and Radiological
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Reference Ticket
Your Yearly Deductible is the amount you must pay out-of-pocket for each benefit period (typically 12 months) before the insurance company will start paying. For example, if your deductible is $500, then you must pay the first $500 of your bills during the benefit period.
This is the Deductible amount you have already paid during the current benefit period. For example, if your deductible is $1,000 per benefit period and you had a medical service performed for $300, then you paid this full $300 medical service out-of-pocket, and you have $700 remaining on your deductible.
A Co-Pay or Co-Payment is a fixed amount that you pay out-of-pocket each time you go to a hospital for a medical service. For example, if you have a S20.00 Co-Pay that means you owe this amount every time you have a medical service and this amount is separate from the amount you will be billed for your deductible and co-insurance.
This is the percentage amount that your insurance coverage pays after your deductible has been met. For example, if you have a $1,000 deductible and a 20% Co-Insurance, then for a $2,500 surgery bill, you would pay the first $1,000 as your deductible. The balance would be $1,500 ($2,500 less $1,000). Of the remaining $1,500, you would pay 20% per your Co-Insurance and your insurance company would pay the remaining 80% of the balance. In particular, your 20% Co-Insurance payment of the balance would be S300 (20% of $1,500) and the insurance company would pay $1,200 (80% of S1,500).
This is the most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.
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