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Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Dumb question - insurance
We just had our insurance rep here to talk about our options w/ open enrollment. And for whatever reason I have a mental block w/ the term "deductible." I think I see it more from the car insurance definition, but not as much w/ the health insurance. I don't know...I have had it explained to me a million times and it just doesn't stick. Can anyone explain it to me so that I "get it" for once!
TIA 
Re: Dumb question - insurance
To my understanding "deductible" is the portion that you will always have to pay for the service you're requiring. I thought in health is was considered "co-pay" and not deductible....
Not much help...
what are you having trouble remembering? how it works?
i hope i get this right but here it goes using my insurnace
i have a $500 deductible..after i meet that i'm covered at 80%
co pays dont apply towards the deductible (ie go to obgyn and you have $35 copay, that covers the exam etc...but then the lab test lets say you owe $20 out of pocket on that after insurance covers everything...that $20 would be applied towards your deductible)
PP's got it right. The amount depends on your insurance. Mine pays 100% after the $500 deductable is met. Typically simple doctors visits are not required to have deductables. They are usually just for procedures and hospital stays....at least with my BCBS plan. Copays are not included in that.
Not sure about all insurance plans but Childbirth is exempt from having to pay a deductable. I paid $20 at my first visit and that is it. I will not have to meet a deductable for the hospital stay.
No problem
being covered at 100% is awesome.
I eventually will change my insurance to be $0 deductible with coverage at 100% when we have kids because i think its worth it and being able to go to the doctor/hospital knowing i wont get a bill afterwards.
in the most part higher deductibles, $500, 1000, 2000 equal lower monthly insurance payments...
The main thing you want to look at is what coverage you get after you meet a deductible (ie 50%, 70%, 80%, 90% 100%) and what actually is covered.
There are some really crap companies out there (i worked in a dr office and did insurance stuff and make people pay a ton and wont cover crap)
Ponder-ing whether or not to become a Viking's fan
Actually deductibles also include doctors appointments with specialists. So, you only pay your standard copay when you go to a PCP or OB/GYN but any other "specialist" you have to pay full price and it goes towards your deductible. For example, I'm diabetic and I see an endocrinologist every 3-4 months to manage my diabetes and I have to see an ophthalmologist every year to have my eyes checked because of my diabetes. Anyway, these two docs are NOT covered by copays until my deductible is met, meaning I pay full price to go to them until I meet my deductible. I'm not sure if this will even apply to anyone else, just thought it'd a good FYI though.
My deductible is $300 and after that my insurance pays 80% and I pay 20%. That's the lowest deductible I've ever had, so I'm stoked about my insurance right now!
It's amazing how different all the plans are. I feel like we have a good plan here at work, but I guess that just if you are in the norm - no major probs expected. Maybe we can set up like our own HSA to pull from when the baby-hospital expenses start rolling in. That's another reason I am glad I have my AFLAC coverages too - supplemental cash flow!
Layne...I just saw a fetal specialist last week and only had a copay to pay so it just depends on your plan.
Shana...Amen for Aflac. I am waiting to start collecting that cash flow.
Actually, I think anything pregnancy related has a whole different set of rules, like you mentioned above. I have no idea what my plan is related to pregnancy stuff, for obvious reasons. I really should look that up though.
Do you know if your hospital stay/labor will fall under the deductible, or will you have a regular copay for it? With my insurance, I pay a one time fee of $500 for anything that happens while I'm in the hospital.
I am going to have to check on that sooner than later, esp if the rules are different for maternity...which may end up in my favor (I hope). $500 isn't too bad, I could manage that w/o an issue, but some of these other plans they were showing us were like $3000+ !!
I think everyone did a great job explaining it. I hate health insurance anymore... every plan sucks and drains every last dime out of your bank account! lol...