Galveston & Houston Ophthalmologist Dr. Da-Thuy Van commented on insurance copays, coinsurance and deductibles. “Understanding insurance copays, coinsurance and deductibles is very confusing. With the ever-increasing cost of healthcare, many patients find themselves with higher copays, coinsurance and/or deductibles. It can be confusing to understand all of these terms but it is a very important that patients take part in understanding their medical bills,” explained Dr. Van.

A co-payment, or co-pay, is the flat amount the patient pays each time they see their medical provider. Your insurance establishes these fees up front and many insurance companies print this information on your insurance ID card. Coinsurance and co-payments are not the same thing. A co-payment is a set amount that you pay each time you see your medical provider. On the other hand, coinsurance is typically a certain percentage of the provider’s fee that is owed by the patient. For example, some insurance companies pay 80% and the patient is responsible for the remaining 20%. That 20% is the coinsurance that is due from the patient per the insurance company. The amount the patient owes will vary based on the fee for the service. A deductible is a fixed amount of money that the patient must pay before the insurance company begins making payment. For example, let’s say a patient has an insurance policy with a $100 deductible. If the insurance considers $300 of the services provided as “covered” services, the patient must pay $100 and the insurance will pay the remaining $200. Deductible amounts are typically calculated yearly so that means that beginning January 1st of each new calendar year, you must meet your deductible before your insurance will issue payment. If you have any questions insurance copays, coinsurance and deductibles, please contact The Eye Clinic of Texas at 800-423-3937 and we will be happy to help.  

The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.


Comments are closed.