First-dollar health coverage implies that you will have your health care costs covered without the initial deductible or copayments. Every dollar of your hospitalization cost and healthcare expenses is inclusive in policy cover. This type of health coverage has burgeoned in popularity in recent times as increasing deductibles have led manifolded the financial burdens of the healthcare industry consumers. The lack of lifetime maximums, free preventive care, and other benefits that come along first-dollar coverage have made people realize the significance of this kind of health coverage. How does this coverage work? Explore it all here.
What Exactly Is First-Dollar Coverage?
You can avail of first-dollar coverage plans on your health insurance policy. A first-dollar coverage can be availed up to the entire amount that’s provided by the insurance plan. However, this ‘entire amount’ is comparatively lower than that of the deductible-based policies that are commonly available. This is probably the primary reason why first dollar plans haven’t been able to garner more popularity than deductible plans. For instance, several first dollar plans tend to have low limits, implying that there exists a cap on the maximum sum that will be covered by the insurance company.
Also, higher premiums are attached to these first dollar insurance plans since the insurer is at a higher risk for the item that’s insured. First-dollar coverage is supposed to be a feasible alternative for people who need to have access to healthcare services that they need to avail repeatedly and quite often.
What Impact Does First-Dollar Coverage Have on Your Deductible?
First-dollar coverage straightaway helps you avoid paying your deductibles. This implies that you don’t need to shell out a particular amount of money in the form of deductibles to have access to healthcare services. You can make use of that service at a price that your plan states. So, which are the services that first-dollar coverage covers?
Usually, a majority of the plans that have the first-dollar coverage incorporated into them would allow you to have pretty easy access to urgent health care visits, emergency room visits, and specialist doctor visits. On certain occasions, a first-dollar coverage plan might also permit a beneficiary to visit a chiropractor before paying the deductible. Certain providers might as well put a restriction on a few services. The moment you reach your limit, the service is added to your deductible, which means your out-of-pocket expenses may increase if you are opting for this plan.
How Can First-Dollar Coverage Impact Maximum Out-Of-Pocket Expenses?
Though you can avoid your deductible with the help of first-dollar coverage, you might not be able to avoid paying your Maximum Out-Of-Pocket. There are not many known ways to bypass this, except a situation when your health plan doesn’t cover a particular service, though that’s indeed an exception. As far as First-dollar coverage is concerned, not meeting your deductibles while meeting the Maximum Out-Of-Pocket is only theoretically possible, and not practically. The probability of this happening is almost next to impossible.
What Impact Does First-Dollar Coverage Have on Your Copays/Coinsurance?
After you pay off your deductible, you step into the copays/coinsurance stage. A copays/coinsurance stage is a phase where your insurance company takes care of the costs associated with your medical claim. The company is supposed to handle the significant portion of your expenses. In the coinsurance stage, you either make a partial payment of the cost or a fixed amount as a copay. How does your first-dollar coverage get you covered in this stage? In maximum cases, your copays won’t change, thus allowing you to continue with the plan. Aside from that, it would become more comfortable for you to use the plan. The bottom line is that your copay in the coinsurance stage and the deductible stage remain the same.
First-dollar coverage is ideal for patients who need frequent access to specific healthcare services. If you are suffering from a chronic condition, you will not have to pay deductibles while filing a claim, and the coverage starts right from the moment you cough up the first dollar. However, always keep in mind that these plans come with higher deductibles compared to similar deductible plans. Choose your health insurance policy wisely.