understanding your medical insurance

[LivingAlmostLarge]

We switched insurance companies with a new job earlier this year. First time we've ever a plan with a deductible. Usually I have co-pays I get that. I also get the deductible. But I'm just not understanding why am I being charged a dr co pay, a hospital fee (children's hospital) where the dr office is? Isn't it all one fee? Also there are two deductibles. Is it my understanding that we have a $200 max deductible then an out of pocket $1500 and $600 family and $4500 family OOP? The co pays go to the $4500 is that right? Also do prescriptions go to the max OOP?

Also is it common to have dental with medical?

[ua_guy]

A copay goes towards your deductible, which goes towards your OOP max. Once you hit your deductible, insurance pays a set percentage. If you have coinsurance, you are on the hook for that up to $4500, less any deductible or copays already paid that year.

The bill from your clinic includes the visit with the physician, and a hospital facility fee, it sounds like. The facility fee is charged because the clinic is affiliated, "part of" a hospital system, versus being a free-standing clinic. It's a way for the hospital to recover the additional expense of expanding administrative and other services to the clinic facilities.

On the last question, I don't really know. Some dental services are actually billed as medical, to your health insurance, whereas stuff like routine dental cleanings, X-rays, exams, are billed via a dental plan, and not to your regular health insurance. I don't know if that answers your question. There are insurers that also offer dental plans, along with health insurance. Aetna is an example.

[LivingAlmostLarge]

Gotcha. Guess i have to start paying everything.