Are Copayments Really Necessary_


Published on

  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Are Copayments Really Necessary_

  1. 1. Are Copayments Really Necessary?I have a very good PPO insurance plan via my employer. This covers just about anything i would likeit to cover, with modest co-pay for doctor visits and a twice copayment if I need to see a specialist.I am at the cusp of becoming somewhat debilitated in my older years. I am 54 years old, and I havebeen completely told that I need a knee replacement, as well as lately because of an injury that Isustained at work , I may need a total wrist reconstruction. I have been spending a lot of money incopayments recently within my doctor’s office visits (ive more than one doctor). These copaymentsrange from $20 per visit for my primary care physician to $40 per check out for a specialist. Ive got a$150 copayment if i have an emergency. At times I see two specialists a week.But what is the copayment for? Is it to offset the office costs of having a clerk pull your file and makea new visit ? Does the money go into the doctor’s petty funds fund, or used for office payroll? in casea specialist’s office (which often houses more than one doctor ) has 100 patients a day, that is$4,000.00 a day taken in with the appointment window, not forgetting what the insurance companiesspend.After a little bit of research, I have learned that the copayment can be a payment that is compensatedby the insured person each time a medical support is assessed (DUH!). Technically, it is a kind of“coinsurance”, but it doesnt usually contribute toward any policy out-of-pocket maximums whereascoinsurance payments do. Through what I learned, the actual copay is quite normally a small portionof the specific cost of the medical service, and it is meant to prevent people through seeking medicalcare that may not be necessary. The theory is that with no copay, people will mistreatment theinsurance coverage more than they might if they had to produce a payment each time a medicalservice is rendered.But through the same token, copayments can also discourage people from seeking essential medicalcare. Unusually large copays can cause visitors to not seek medical care at all simply because theycan’t afford it, manifestation someone “uninsured” that in actuality has a good insurance policy. Therehas to be a happy medium. Policies need a high enough copay to ensure that people will bedissuaded from abusing the machine , while maintaining a low enough one to keep the insurancecoverage from becoming worthless.Because associated with my injury, ive missed a lot of function. Worker’s Comp is still fighting it, and ialso have lost about a month’s wages in the last forty five days. My doctor , a specialist, is billing theco-pays in my experience in an effort to help me have the treatment I need. The good news is I havebeen sent to one more specialist, one that is planning to determine the extent of my handreconstruction. He won’t even say “hello” to me until we pay the $40.So we wonder to personally , “What about the Hippocratic Oath”?So I read it. This says nothing about money.I remember a time in the past in the Midwest once i needed medical care for my young child. I couldnot afford to take him towards the doctor, so the doctor worked out a deal with me. All I had to do wasclear the snowfall away from his office parking lot, and spade his personal stroll and driveway with his
  2. 2. house. I had to spend all day to do this by hand , and I felt personally rewarded by the knowledge.The doctor was delighted as well, and had us over to his house for dinner.I guess that even though everybody has their illnesses, medicine is still big business. Even with theveterinarians. In the event that we have an illness, just like we have hunger, we can’t achieve ananswer at either the actual doctor’s office or perhaps the grocery store until we pay for it in funds.Such is life.Copyright 2011 by delete Banks101Costa Rica medical tourism