Hospital Copay- $200?

Question

Why are PCP copays less than hospital copays? Why is there a hospital copay to begin with?

Answer 1

If there is a PCP copay why not have a hospital copay?  Have you ever thought about what each visit could cost?  PCP you see up to what 15 minutes and they charge for an office visit.  The hospital you could be there for months.  How many doctors, nurses and others that you see, what about the meds that they give you, x-rays, the bed that you stay in, a surgeries that you have etc.  

I work for an insurance company and there are plans who do not have copays for anything and others have a deductible they have to meet for those individuals who are contracted-participates with the insurance company!

$200 hopsital copay, consider yourself lucky, It could be $200 per day! :-)

Answer 2

No clue, but I get to spend $600.00 on an ambulance ride and Xrays, CatScans etc. if my insurance decides not to cover me from an accident in Feb! ugh.

Answer 3

You have to meet your deductible, and that is why there is a co-pay.

Answer 4

The size/amount of a copay is related to the intensiveness & cost of the service. PCP office visit usually costs between $100.00-$500.00...

Going to the hospital can cost anywhere from a few hundred dollars, and up.

You have a copay because that's the insurance you picked. Not all plans have the same patient financial responsibility.

Answer 5

The assumption that PCP copays are less than hospital copays, isn't correct.  And on some plans, there aren't hospital copays, either.  

Like mine, through my husband's employer.  

It's all about the plan.  Electing copays keeps the premiums lower for the employer and employee.

Answer 6

Probably because those are the terms of your policy.  PCP copays are always less than hospital copays.

Answer 7

PCP co-pays are less because a physician office visit cost less than a hospital stay. A stay in the hospital is usually a deductible instead of a copay but either way $200 is cheap compared to some. One day in the hospital would cost thousands of dollars without insurance compared to a doctors visit which is usually around $80.00 depending on  where you live

Answer 8

usually there is a hospital co pay.....but they will bill you for it......thats what i do....

Answer 9

I hope this helps but you need a copy of your plan to verify what may pertain to your policy.  Most insurance policies have a copay for Office Visits with the primary care phys and a copay for er visits, er visits have higher copays because they charge a lot more and most insurance companies realize that people go to the hospital for things they could do at their PCP or thru an Urgent Care facility.  Some insurances do waive the copay if the patient is admitted.    It truthfully is a way to keep costs down which will ultimately reflect on your premium.  Now if you have a yearly deductible that means you have a specific amount (usually a per person /single amount and a general family amount) you pay to your providers then after that is met the insurance company pays their percentage.  For example my insurance (granted mine is extremely low, I have excellent coverage...knock on wood)  deductible is $50 per person or $100 for a family, my deductible will never exceed $50 for one patient in one year.  I have a $50 ER copay and a $25 office visit or Urgent Care copay.  So the way I get around it is I don't go to the er unless I am extremely injured or so sick that I can't wait till morning I go to urgent care or my pcp, so unless it's necessary I don't do it and it saves money for me and the insurance company and my premium is low.  People really need to become more self aware of their policy's.  There is no such thing as 100% coverage no copays or deductibles any more, and people need to learn that and learn more about making their policy work for them

Answer 10

Most people, including people in the health industry, evidentally understand what a "co-pay" is!

A co-pay is a minimum payment usually based on an 80/20 split between an insurance company and the policy holder.

The charges that are made to a patient which seem to exceed this formula are normally to meet a DEDUCTION.

The Deduction must be made prior to the co-pay taking effect.    

It just shows the ignorance of health-care people when they refer to a deduction as a co-pay.