Want to know how to calculate Blue Cross blue Shield drug rehab benefits?
You’ve made a decision to go to rehab. Great! You have a Blue Cross Blue Shield policy. Great! How much much does your plan cover and how much will you have to pay out of pocket? We’ve written this guide in an attempt to help you calculate your out of pocket costs. To do that, you first must understand your policy and how it works.
What is a Deductible
Health care practitioners must charge you a deductible, if your policy has one, before they can collect from insurance companies. The amount you pay your doctor or health care service providers is called a deductible. So, the deductible must be paid first before you can use your medical benefits under your insurance plan.
How it works: Let’s assume your deductible is $1,500 and addiction treatment is 20,000. You must pay $1,500 first before your insurance kicks in. After you satisfy your deductible, the rest is covered by your health plan under behavioral health benefits.
What is Coinsurance
Most insurance plans cover 60% to 90% of medical expenses. In other words, you and your insurance company share medical costs. This is known as coinsurance. You start paying coinsurance once your deductible has been met.
How it works: Using the example above, your deductible is $1,500 and the cost of treatment is $20,000. You’ve satisfied the $1,500 deductible and now your medical benefits kick in. If your coinsurance is 80% then you would be responsible 20% of the costs plus the deductible. In this example 20% of $20,000 is $4,000 which is your coinsurance amount.
What Is Max Out of Pocket & How to Calculate It
Max out of pocket is exactly as it sounds. It’s the maximum amount of money you can expect to pay for any and all medical services in a 12 month period. Going with the example above, your deductible is $1,500, coinsurance is 20% and out-of-pocket maximum is $5,000. Your deductible and coinsurance add up to $5,500. In this scenario, you’d have to pay $5,000 and any medical expenses after that would be covered 100%. You would calculate Blue Cross Blue Shield addiction rehab benefits the same way.
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