CoPay Health Insurance Plans

The traditional PPO copay plans provide coverage for office visits for both primary care physicians and specialists for set charge. This is the way most group and individual plans have been sold for years.

Other services will have a deductible ranging from a low of $500 to a high of $5,000 or more. The insurance company will pay from 60%-80% of the charges until your share reaches the annual maximum of between $2,500 and $10,000.

Insurance companies have recently changed some of these plan designs for the better. Rather than covering unlimited office visits per year (and including the cost in the insurance premium), many companies will provide coverage for only 3 visits annually with additional visits being subject to a deductible.

Since most people do not visit the doctor more than a few times a year, the cost of insurance does not have to include unlimited visits. This has resulted in plans with much lower premiums that the similar “old fashioned” copay plans. Newer plans also have lower annual out of pocket maximums making them more cost effective for consumers and businesses alike.

It is obvious that prescription costs have increased at a much higher rate than inflation. To combat the effect of this on insurance premiums, plans now are available with the option to eliminate coverage for brand name medication. They will help pay for generic medications. Using Anthem Blue Cross as an example, the same plan with “full” prescriptions might cost 25% more than the same plan covering generics only.

We specialize in making certain your insurance dollars go farther by reviewing these options with you. You won’t get this from simply using an “instant quote” site.