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I have been covered by HMO’s, EPO’s and PPO’s previously where I have had everything from standard $25 copays, to paying 20% of all costs when going to a doctor, hospital or other medical provider. This is the first time I will be under plan that covers it all until the cap is reached. Of course we tend to only go to the doctor once or twice a year at most, our kids are very healthy and have an average of one doctors visit every twelve months, which this plan is ideal for people who are healthy and don’t need to see doctors or specialists often.
The good news is even if there is lots of doctors visits, there is cap on how much I can pay for the year, and once the cap is reached the plan covers 100% of all else again. The cap itself is not much higher than the cap on an HMO where you pay the 10% of all hospital costs until your cap is reached (you just reach it faster with this type of plan). This all goes into effect starting 1/1/2010.
Here to experimenting with my health insurance.
-Justin Germino