You will continue to pay copays and coinsurance until you’ve reached the out-of-pocket maximum for your policy. Copay and coinsurance can mean the same thing, both you and your insurance company will be paying part of what is owed.
When you reach your out-of-pocket maximum, your insurer starts paying 100% of your covered medical bills until the policy year ends, or you switch insurance plans, whichever is first.
You must get permission from your insurance administration to approve the medical services you’re asking for. Usually, it requires medical records and physician documentation to designate why the procedure is requested. It must be approved BEFORE you receive...
Pre-certification is a notice sent by your healthcare provider to request elective, non-urgent services to a health insurance company. As with pre-authorization, the insurance company determines the decision to cover the service.
