There is alot of confusion regarding insurance coverage, In-Network benefits, Out Of Network benefits and what you, the patient, are required to pay for treatment.
The chart below lists the major differences between In-Network and Out of Network benefits.
In- Network (I-N) |
Out of Network (O.O.N) |
Difference |
|
Deductible |
Possible | Yes |
OON usually higher |
Co-pay ( pt pays) |
Depends on Policy |
Yes |
Co-pay out of network |
Percentage pay (pt pays) |
No |
Yes |
Less than Co-pay/visit |
# Visits limit/yr |
Possible |
Possible |
|
Insurance payout limit |
Yes |
Yes |
Choice of Doctor |
Only within network plan |
Unlimited |
Your choice of Doctor |
In summary:
- Each category of benefits typically has a deductible. This is the amount you must first pay before the insurance company will even consider contributing to the cost of your care
- Co-pay(s) are associated with In Network benefits. The amount of co-pay ranges from $15-75 per office visit.
- Percentage pay is generally limited to Out of Network benefits. The insurance will pay a percentage of your visit. The most common seen in this office are 50/50, 60/40 and 70/30. The patient is responsible for the smaller percentage. This can be more cost effective than In Network co-pay, especially if the co-pay is close to the cost of the office visit.
- Limitations of visits and insurance contribution is seen with both In and Out of Network benefits.
- Dr. Kanzic accepts all plans and is an OUT of NETWORK provider.
- Dr. Kanzic accepts assignment on MEDICARE.
Please feel free to contact the office at 713-683-6800 to discuss your insurance benefits - ask for Jessica. We hope to hear from you soon !