Lucid Health
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Health insurance agency, providing transparent consulting for solopreneurs, businesses, families, an NPN# 19458132
12/28/2023
Understanding Health Insurance Terminology - Copayment:
According to HealthCare-dot-gov, this is defined as:
"A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service."
A copayment (or "copay") is a more reliable price point when you go to the same provider. These range in price - depending on your plan.
Fixed indemnity plans do not offer copays. These types of plans pay a specific amount for each service provided by a provider. This creates a more variable cost point for patients that go to multiple providers. However, many times the fixed indemnity plan will create less cost for the patient for routine services. Specialties, hospitalizations, or more complex and uncommon services could create a much larger risk profile for these types of plans.
Share any questions or concerns with us in the comments, or connect with us directly for more personal service.
12/21/2023
Understanding Health Insurance Terminology - Claim:
According to HealthCare-dot-gov, this is defined as:
"A request for a benefit (including reimbursement of a health care expense) made by you or your health care provider to your health insurer or plan for items or services you think are covered."
Too often we see clients believe once they have health coverage in place, everything is covered 100%. However, the premium only covers the cost to HAVE coverage. Whenever you have any service performed by a provider, a claim is submitted to the insurance company to pay their portion of that service. Any remaining cost will be the responsibility of the patient receiving the service.
Share any questions or concerns with us in the comments, or connect with us directly for more personal service.
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