Does Copay to See Primary Doctor Count Towards Deductible?

[badkitty]

I recently switched to a different health insurance plan.

The old one that I had had zero copy to see my primary doctor and a $1000
deductible. When I go in to see the doctor, I just give the receptionist my
insurance card and there was no fee for the visit. I think I've only used it
4 o 5 times during the last 10 years. It was a simple plan and I paid very
little attention to it. There was also no need to think about the deductible
because the company had a fund that paid the deductible for employees,
if necessary. I had to give it up when I went to work for a new company.

With my new plan from Blue Cross, there is a $10 copay. The deductible
is now $2000. I don't know how this works now. If I go to my primary
doctor, do I just pay the $10 and Blue Cross picks up the rest? For example,
if the doctor's fee is $100, do I just pay the $10 co-pay and Blue Cross
pays the $90? Does the $10 count towards the yearly $2000 deductible?

I still have not received the policy material and their website doesn't
say anything in detail. I called them a couple of times but gave up after
being on hold for 1 and 2 hours. (the recording said it was due to the
extra volume of new customers trying to sign up before the deadline)

Can someone explain it to me?

Thanks!

 

[somarco]

The copay probably does not count toward your deductible. Ask your agent, HR or wait for the policy.

Did you read the summary before buying this plan?

 

[badkitty]

The copay probably does not count toward your deductible. Ask your agent, HR or wait for the policy.

Did you read the summary before buying this plan?

Guilty as charged... I didn't read anything except the prices. :(

I guess my punishment is to continue holding for a Blue Cross
agent to come online.... I've been on hold for the last 1 hour 10 minutes.
(this morning I gave up after 2 hours)

 

[bluediamond]

In Florida? Then no your copays do not go toward your deductible, but they do towards max out of pocket.

 

[YouGotMyMoney]

In Florida? Then no your copays do not go toward your deductible, but they do towards max out of pocket.

so the answer is YES.

as in a layman expects insurance plans always pay 100% the deductible, so yeah it goes to your out of pocket for the year

 

[Milkman1265]

co pay is for showing up
then you're responsible for your deductible before the insurance kicks in
after your deductible co-insurance kicks in and you are responsible for that portion
until max out of pocket is reached, then they cover it all.

 

[DS4]

Does the $10 count towards the yearly $2000 deductible?

I have never seen an Anthem Blue Cross plan where the copay applied towards the deductible.
Max out of pocket, yes. Deductible, no.

 

[MIM]

Let me re ask this question because I'm still in outer space on this one. So please bear with me and please and thank you beforehand. Here's an example:

XYZ Health Insurance Plan
Copay is $30 for Primary
Deductible is $2500/$5000

I've noticed on some plans it'll say something like $30 for 4 visits, then subject to deductible and coinsurance. If it doesn't give this sort of notice, or an asterisk or special note, can I assume that the deductible has to be paid first BEFORE the copay is enabled ?

Thanks guys!


MIM

P.S. I forgot to mention that I'm in Southern California if that has any relevancy to the answer.

 

[somarco]

some plans it'll say something like $30 for 4 visits, then subject to deductible and coinsurance.

Yes, some plans work that way, but the copay does not accumulate toward the deductible.

Frankly, I don't know why these questions come up. Obama designed these plans so that all you needed to know was bronze, silver, gold, platinum. Just like ordering an airline ticket on Kayak.

Everything is so much easier now than it was before.

 

[Norwayguy]

Yes, some plans work that way, but the copay does not accumulate toward the deductible.

Frankly, I don't know why these questions come up. Obama designed these plans so that all you needed to know was bronze, silver, gold, platinum. Just like ordering an airline ticket on Kayak.

Everything is so much easier now than it was before.

Aren't you the comedian.