What does cost per pay mean?

Question

Im talking about medical insurance thru my company. There are a few deductible options to chose from, and then it breaks it down into "cost per pay" catagories. What does this mean? Does the deductible last for the whole year and then the cost per pay is taken out of each pay check?

Answer 1

Once you have paid the deductible , it is met for the entire year. The deductible comes out of your pocket and is paid to a medical provider once services are rendered-sometimes at the time services are rendered or better, once the insurance has received the claim and processed it and you receive the bill from the provider. The cost per pay is the amount of the premium that is being taken out of your check every pay period to be enrolled in the insurance coverage. This amount is separate from any amounts due from you to providers once services are received.

Usually, the higher the deductible and out of pocket maximum, the lower the premium. You need to consider how much you use the insurance and how much you can afford to spend if you use the insurance. Another consideration is if you have a doctor, is he/she a part of your "network" or will you have to change doctors? They may also be offering you a choice between HMO and PPO. Usually, an HMO is more premium, less out of pocket, but you also have less choice in doctors and care since all you care is managed through a Primary Care doctor. The PPO option is usually more expensive in premium and out of pocket expenses, but you get alot more choice in the doctors you can be seen by.