Benepath: Heath Insurance Co-Pays Don’t Cover What You Think They Do

Co-pay coverage isn’t what it’s cracked up to be. That might seem astonishing, but the bottom line with co-pay coverage is that it only pays for the visit to the doctor’s office. Diagnostics are separate and those cost extra.

Knowing what a co-pay plan actually offers is better than finding out what it really includes after you use it. There seems to be a psychological component to co-pay plans, in that people feel they are paying less and are covered for everything. That is not the case.

Co-pay plans pay about $20.00 for a $30.00 benefit. This is like buying an insurance policy for your car and asking for oil change coverage. It’s a small benefit and not worth covering, is what it amounts to. Look at it another way. When ordering food off an a la carte menu, the prices are rarely evident. Ordering is pure guesswork as to what will arrive at the table. But no matter what was ordered, someone has to pay for it even if less value was provided than the money owed.

Many people are so hooked into co-pay benefits because they feel they are getting value for their dollar. They don’t realize that when they leave the doctor’s office and go to the lab or other places for further diagnostics, that the cost is not covered. It’s extra. The fact of the matter is that many who choose co-pay plans have no idea what the real cost of services are when they see the doctor.

Choosing co-pay plans seems to be a reaction to fear of the unknown. The irony lies in the fact that if the choice of plans had been discussed with a local health insurance agent, the person would have had a choice of plans that suited their circumstances the best, and would have gotten much more value for their health care dollar. It can’t be emphasized enough–the local health care insurance broker can sort through thousands of options to tailor a plan to a particular situation. The advice is free, and the savings may be substantial.

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