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Then I don't know what definition of deductible your insurance company is using, but it doesn't match my experience with any insurer ever, health or otherwise.


It's simple - I have a flat $500 copay for an "ER encounter" regardless of what they do in the ER. Just like you have a $40 or whatever copay for a regular doctor visit.


The deductible must be paid before copays come into play. If you have a $2,000 deductible, then you will pay whatever the insurance company has negotiated with the in network provider for the billing codes the provider bills, up to $2,000. After that, the copays amounts come into effect.

https://www.investopedia.com/ask/answers/051415/what-differe...


No, that's not how it works.

Most health insurance plans have a few services that are copay-limited even before you hit your deductible. i.e., the $40 for an office visit to your primary care doctor, $90 to see a specialist, and in my case $500 for the ER visit. Imaging and procedures are my problem from the start, up to the deductible though ... apparently unless they happen in the ER.

Like I said way up-thread, the way it's structured puts the incentives in the wrong place for me. Had my two visits for ER and scans been in the opposite order, I would have been out of pocket the same total.

Anyway - I'm done arguing with you. I know how my plan works and what I've paid this year, whether you believe me or not.




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