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Health Alliance Plan Doctors

Posted in Uncategorized | August 27th, 2011

health alliance plan doctors
health insurance question?

I currently have three part-time jobs. One of my jobs provides very minimal health insurance coverage that has a lifetime maximum coverage of $5,000. When I go to the doctor, I have no co-pay or deductible, but they only cover up to $5,000. I was told I should purchase supplemental health insurance that has a $5,000 deductible. I live in Iowa, 23 years old, and not a smoker. What is a good company to go through?

When I have looked at different insurance plans I am kind of confused of what certain things mean on the example below? Could someone explain how much I would pay for different situations? Thanks so much!!!

Deductible: Single $5,000
Coinsurance: 50% except hospital in-patient services which are subject to 25% coinsurance (other than mental health and chemical dependency)

Office Visit (Alliance Select Providers): $30 per visit if one of the first 3 total visits in a benefit period(3). Subsequent visits, you pay deductible followed by 50% coinsuran

A $5000 lifetime maximum is not very much; you could use that up with one day in intensive care.

Yes, you need another plan because as soon as you reach $5000 with your current plan you won’t get any more benefits.

The deductible is how much you pay before the insurance benefits kick in. The deductible can be per year or per occurance; most good policies have it per year.

Coinsurance is the percentage of the charges that you pay after you reach the deductible. You did not specify if the policy had a maximum (the good policies do). When you reach the maximum coinsurance per year the insurance pays 100% of the covered charges.

The office visit is how much you pay when you go to the doctor. Most policies have the office visit not subject to the deductible, although with some policies you have to pay the deductible first. It sounds like yours is not subject to the deductible. You will get 3 visits per year for a $30 copay. If you need more than three you will pay the full price until you’ve reached $5000, then you’ll pay 50%. Also, some policies do not cover lab and x-ray costs under the office visit so you may be paying full price for those procedures as well.

There are many good companies. Visit a local independent agent that works with all the major companies. The agent can check to see if you’re current doctor is in the plan that he recommends and can explain the coverage provided by the policy. The plans and premium is exactly the same whether or not you use an agent.

Don’t consider this as a supplemental policy. This can be a secondary policy to pay for anything that your current policy won’t pay for but it will become the primary policy once you reach your $5000 lifetime maximum.