Help Center

Sometimes- where you are geographically can play a role in determining price. In areas with more than one provider, like larger metropolitan cities, there are more options and therefore some competition, which can result in options for better pricing.

Co-insurance is how you and your insurer split the balance on the reimbursement amount after the deductible has been met. For example, if you have an 80/20 plan, you have to pay 20% of the remaining balance after meeting your deductible. You insurance will pick of the other 80%. So, if you have a bill that is $5,000 dollars and an 80/20 plan, after reaching your deductible, you would be responsible for paying $1,000 of that bill.

RBCs are urgent care centers are usually staff with on-site Registered Nurses or a Nurse Practitioner and co-located with a pharmacy, department store, or grocery store. They provide non-emergency care and their services are generally provided on demand, often making them more accessible than an ER or even a primary care physician. While an RBC is not a substitute for a primary care physician, they can save you time and money. By eliminating traditional office staff (receptionist, nurses, back office staff, etc.), they are able to offer services at a savings to the customer. Moreover, you do not have to wait for an appointment and can enjoy walk-in health services.

Often times, lower premiums equal less coverage and/or a more limited choice of providers. Conversely, more coverage equals higher premiums and/or more choice of providers. Your premium can also relate to your deductible. If you choose a plan with a higher deductible and thus great patient responsibility, expect a lower monthly premium.

Premiums vary for a number of reasons. First, different insurers get different rates with providers depending on their leverage and ability to negotiate reimbursement. The size of the group covered can also play a big role in the cost of health insurance. The bigger the group, the easier it is to assess, and the more people over whom the risk can spread. This often results in a lower rate, while a smaller group often results in a higher rate per individual. Of course, there are always exceptions. For example, if a larger company has an older workforce, they may see higher rates because frequency and severity of health issues tend to increase with age.

Calculating your mileage will benefit you because you may be able to write off the expenses on your taxes. Transportation costs associated with healthcare needs, along with many other medical expenses, are tax deductible if your outlay for medical expenses is more than 7.5% of your adjusted gross income. Check out the IRS website for more information at www.irs.gov.

Balance billing occurs when a provider (doctor, hospital, clinic, etc.) bills a patient for the portion the insurance company “writes off” or discounts. A provider has balance billed you when they attempt to recoup some of, or all of the entire “network” discount.

Patient responsibility is an insurance term that refers to the amount that you owe the provider based on information sent from your provider to your insurance company. This should include any co-payments, deductibles, co-insurance and/or excluded charges.

Yes. Because your insurer negotiates with providers to try and get you the best rate, some doctors and hospitals get more for services than others do. Big companies leverage their size to get better reimbursements.