how does this insurance work?

Sunday, January 30, 2011

http://www.humanaonedental.com/affordable-dental-care-details.aspx?productId=131 i am 18 so i am just entering this insurance world and i have no idea what dectables are and copays are so how does the billing work with this insurance policy?? http://www.humanaonedental.com/Schedules/DHMO/005c550.qxd.pdf
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Insurance companies are in the business of denying health care, they are for profit and if you cost more than that get from you they would go out of business(whens the last time you saw an insurance co go under??) You go to the hospital, your doctor says you need this procedure. You have a co-pay for the visit(this you pay out of pocket) The insurance company says thats not covered or we will only pay X amount. They have nurses and doctors on staff to argue with your doctor etc about the necessity of the procedure. Doctors and hospitals raise the rates they charge to cover the costs of all the time spent arguing with the insurance company. Normally you have to pay up to the limit of your deductible say it costs $5000.00 and you have a $1500.00 deductible you pay $1500.00 and the insurance co pays the remaining $3500.00. Sometimes this is a yearly deductible so the next procedure (in a given year) will not cost you out of pocket. However(a big however) You insurance probably has limits as to how much they will pay for the procedure. They may say that they will only pay $2000.00 for this procedure. You pay your $1500.00 deductible Insurance pays $500.00 and then the doctor sends you a bill for $3000.00
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