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Phone: 309-661-9975
Heartland Foot and Ankle Associates
Call 309-661-9975
Toll Free 866-274-0285
Fax 309-661-9920

Insurance Terminology

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At Heartland Foot and Ankle Associates, we strive to educate our patients not only on their health, but also on their insurance benefits to make them a more educated health care consumer. Informed patients make better decisions about their health and well being. With the start of the New Year brings many changes to most insurance plans.  With so many different insurance terms, benefits can seem confusing or unclear.  We're here to decode four common terms found in an insurance policy and benefits.

  1. Deductible: A flat monetary amount that the insured is responsible to paying toward his health care before the insurance company has to pay anything. 

    For example, if an insurance policy has a $1,000 deductible, then the insured is responsible for paying his medical offices for the first full $1,000 of health costs incurred, then the insurance company will begin paying toward health care costs (and not always at 100%).
     
  2. Co-insurance: A percentage of the allowed amount that the insured is responsible for paying toward his health care each and every time a claim is filed under his policy (every time he sees the doctor).  

    For example, if an insurance company has a $500 deductible and 20% co-insurance, then the insured is responsible for paying his medical offices for the first full $500 of health costs incurred.  Then, after he has met his $500 deductible, the insured is only responsible for paying his medical offices 20% (instead of 100%) of the allowed amount of health costs incurred, and the insurance company pays the other 80%. 
     
  3. Copayment: A flat monetary amount the insured is responsible for paying toward his health care each and every time a claim is filed under his policy (every time he sees the doctor).  

    For example, some health insurance plans have copayments in place of deductibles and co-insurance.  In this case the insured is responsible for paying a co-payment, flat monetary amount versus a percentage, to his health care provider.

If you ever have a question regarding your podiatric insurance benefits please feel free to give our office a call and our Billing Coordinator, Kristi,  would be more than happy to verify and review your benefits.

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