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Explanation of Medical Insurance Deductibles in Colorado

In Colorado, as in the rest of the Untied States, health care costs increase at a rate more than double the national inflation percentage. Health insurance carriers continue to devise new plans and implement new features designed to keep monthly premiums affordable. Deductibles and co-insurance represent the most common policy characteristics chosen by consumers who need to keep coverage but cannot afford the steadily increasing costs.

  1. Deductibles

    • The deductible is the amount you must pay toward the cost of your treatment before the insurance company pays any claims. The deductible represents your financial responsibility toward your own care. Deductible amounts vary from policy to policy, and are always a fixed dollar amount. Typical health insurance deductibles range from $1,000 to $5,000.

    Co-pays

    • The co-pay is a nominal charge for an office visit to your family physician or specialist. Co-pays typically range from $10 to $50. It is important to note that not all health insurance plans add the aggregate sum of your co-pays into calculating the fulfillment of your policy deductible.

    Co-insurance

    • The inclusion of a co-insurance feature on health policy is yet another method of reducing the monthly premium. Co-insurance represents how the cost of your treatment will be split with the insurance carrier. Co-insurance amounts are represented as percentages, with the insurance company typically paying the larger portion. Common co-insurance percentage splits are 90/10, 80/20, 70/30, 60/40 and 50/50.

    Maximum Out-of-Pocket

    • Without a safety net in place, deductibles and co-insurance could potentially leave consumers with significant medical bills that they do not have the financial capability to pay. For this reason, health insurance plans have maximum out-of-pocket provisions that shift the responsibility for unpaid claims back to the carrier once the consumer has spent a predetermined amount of money on his own care. Maximum out-of-pocket amounts vary by the plan, and typically range from $1,000 to $5,000, but may also be significantly higher.

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