Tip 234- Eye Popping Co-Pays

We all know there are alternatives to Emergency Room visits; e.g., a call to your primary care physician or your insurer’s nurse-line; tele-medicine; Urgent Care Centers.

But then there’s the Mom whose child is bleeding from a head wound. Or, the husband whose wife is having a cardiac event. They’re heading to the ER.

And, if covered by a new breed of health plan, they’ll pay a $500 co-pay. (Usually waived if the patient is admitted to the hospital.)

These new plans might also have $90 or $125 prescription drug co-pays for certain expensive brand name drugs. Are there generic alternatives available? Not always.

Here’s one more emerging trend; 50% co-insurance or, in some cases, no coverage at all, for out of network services.

Plan design features such as these reduce premiums by as much as 30%. So, how will consumers react?

We think that depends on how well they understand their coverage.