In insurance terms what is the difference between Deductible and Max out of pocket expense?
The annual out of pocket maximum refers to the actual amount of money you will pay for your medical cost before an insurance plan pays 100% of your bill. For example, if you have an "80/20" plan with a deductible of $2000.00 and a maximum out of pocket of $5000.00, you would be responsible for paying the first $2000.00 of the hospital bill, then the insurance company would pay 80% of the bill and you would pay 20% of the bill. Now, you've already paid $2000.00 so you have $3000.00 of your max out of pocket to pay. Once your 20% of paying that bill reaches the balance of that $3000.00, you would have paid your maximum out of pocket total of $5000.00 and the plan would then pay the remainder of the bill 100%.
2 people found this useful
Yes, but it might not be a good idea as then the benefit would be taxable. Are you talking about YOUR coverage or for your employees? for more info see www.steveshorr.com/life….htm
A "per diem" or "indemnity" long term care insurance policy willpay up to a fixed amount of benefits. An "expense-incurred" long term care insurance policy allows you tochoose… the benefit amount when you buy the policy. It reimbursesyou for actual expenses incurred, up to a fixed amount per day, perweek, or per month. Note that no policy will pay unlimited benefits. Answer: An indemnity long term care (LTC) insurance pays aspecific daily amount based on your policy, supposed you get anindemnity ltci with benefits amount of $300/daily for a benefitperiod of 3 years, and you require long term care later, let's sayyour daily ltc expenses is $150, you will still get $300 regardlessof your daily ltc expense, you have the freedom to decide where youare going to spend the excess $150. This is fixed for 3 years,depending on the benefit period you choose. So if after threeyears, you still need care, you will have to pay the cost out ofyour pocket An expense incurred ltci reimburesed you with exact amount for yourcare. Supposed you bought an expense incurred ltci with dailybenefit of $200 for 3 years and your daily ltc expenses is $100,you will be reimbursed with $100 and the excess will be kept as asavings so you can extend your benefit period. If after three yearsyou still need long term care, since you saved $100 from yourbenefit amount, the insurance company will cntinue paying for yourexpenses even if you only bought a 3 year benefit period policy,until your savings are all spent.
If you change jobs and health insurance does the amount paid out of pocket expenses for deductible or coinsurance on old policy transfer to your new one in the same year?
\n. \nI don't know of any provision for your deductible or coinsurance to be taken over if YOU change jobs. They must though give you credit against a pre-exisitng condition …clause \nIf an employer though switches from one Insurance carrier to another, then most will give credit \n. \nI have had an insurance company credit the paid deductible for the individual when they switched jobs. The specific circumstance was an individual who was with the same carrier at the old job and had a choice of carriers at the new job. It is likely that they only do this for people who were already with them that have an option to go with another carrier in order to keep them as a client.
There are deductions in the form of exclusions in health insurance.The exclusions are for lst year, 2nd year, showing the details of diseases in the policy bond itself. Even f…or diabetes as "Pre-existing", few companies gives coverage only after 48 months. Deductions are there when the Insurance Company or T.P.A. considers few expenses viz. Aaya charges, cost of bandage, ambulance fare etc. shown in the claimed amount, to be not within the purview of health insurance coverage.
Maximum out of pocket costs is the maximum amount you would have to pay (take out of your pocket) per year. I believe this is total for all incidents. This is an annual cost.,… ie, must be payed each year you have an accident/hospitalization. You would also have a deductable amount that you or your company selected when you purchased the insurance policy. May also say 80/20 You pay 20 percent, insurance company normally pays other 80 percent.
Can I add my monthly health insurance payment from my employer to my medical deductions, such as medications prescribed, office visits, etc..
Group term life insurance is a type of life insurance provided for employees by their employer.. An employer buys a master policy and issues certificates to employees denotin…g coverage under the plan. Group life insurance is also available through unions and associations. It is usually issued as yearly renewable term insurance, but some plans provide permanent life insurance.. Employers may pay all of the cost, or share the cost with employees. Regardless of your reason for termination of employment, employees may have the option to convert their coverage to an individual life insurance policy without evidence of insurability or taking a physical examination. Usually, conversion must be within 30 days of ending your employment. The new premium upon conversion of the policy is based on the employee's age at the time.. An individual life insurance policy is owned by the insured (in most cases). The insured usually pays the premiums and decides who the beneficiaryis for the policy. An indivual life insurance policy insured just one life. A group life insurance policy insures many lives.
An employer's contribution to a group insurance plan is deductible as a business expense. This benefit is not taxable to the employee. An employee may not deduct a portion of …the premium he cost shares with his/her employer.. Typically a group benefit plan includes drug and dental coverage, lfe and long term disability . Where there may be cost sharing of the premium, an employer's contribution shoud always be to the health and dental portion. If any part of the premium for the long term disability is paid for by the employer, should the employee become disabled, then that benefit (usually up to 67% of the pre-disability earnings) would be taxable in the hands of the employee.
A deductible is the initial amount that the insured must pay out of pocket before the insurer's obligation to pay anything is triggered. It might be best understood as the amo…unt for which you have agreed to self-insure before seeking assistance from the insurer. For example, if you have a $1000 collision deductible on your auto insurance, and a collision results in repair costs of $650, you would not have met your deductible, and the collision insurer would not have an obligation to pay. In contrast, co-insurance is that percentage of a covered claim that you are obliged to pay. The context of health insurance probably provides the best example. A major medical policy may provide for a 20% copayment. This means that once any deductible is met, the insurer pays 80% of allowable charges, and the insured is responsible for the remaining 20%.
It's the part of the cost you must pay before the insurance pays anything.
When payment for insurance is made advance of actual expenses thenit is called prepaid insurance which is asset for business untilinsurance benefit is utilized while insurance… expense is actualinsurance expense when insurance benefit is taken.
If you are referring to tax deductibility, yes, long-term careinsurance is tax deductible. Age determines tax deductibiliby.Please refer to the related links below to check th…e limits of taxdeduction for long-term care insurance:
Revenue is the amount of money a business/person makes as a whole. Expenses are things that a business/person has to pay for with their revenue such as utilities that a busine…ss uses. What's left over from the revenue after the expenses are paid for is profit.
Term Life Insurance will protect you for a limited period of time. It is considered pure protection life insurance. You have options for 1 year renewable term, 10 years, 15, 2…0 and 30 years term. Some companies even offer a 40 years term, or term to age 65. Your life is covered for the length of the contract. At the end of the selected term, you have the option to terminate coverage, or convert the term policy to a permanent life insurance (whole life or universal life insurance). Some term policies will return all premiums paid at the end of the term. You have to have the Return of Premium option on the policy in order to get all your money back. Universal Life insurance policy is designed to stay in force for the rest of your life, and it can accumulate cash value. Universal life policies have two components: protection and investment. Premiums are higher for Universal Life, versus Term Life, due to the investment portion which accumulates cash value. Depending where you are in your life and financial situation, term may be your best option if you want to protect your family or dependents for a determined amount of time (until children finish college); or if you want to protect your dependents for as long as you live (up to age 120 is available) then Universal Life or Whole life are your best bet.
The deductible is how much you will pay before the plan starts helping you pay your medical bills. After you reach the deductible, most plans will pay a percentage of your bi…ll and you pay the rest. This is called "co-insurance". Your out-of-pocket will include the deductible and the coinsurance. . Plans set a maximum out-of-pocket amount, after which the plan pays for all of your covered medical bills. . The Affordable Care Act sets limits on deductibles and coinsurance, based upon your family income. You may qualify for help paying these in 2014.
Life insurance is a more general concept that may refer to either whole life insurance or term life insurance. Whole life insurance gathers value the longer you have it, where…as Term life insurance does not obtain any value that you may use before you die. Term life insurance only pays out when you die.