Insurance Deductibles, Coinsurance, and Copays


It is important to provide your insurance information when you schedule your appointment with our office. This will allow us to verify coverage and eligibility for the appointment. If we encounter any issues with your insurance, we can communicate those to you prior to your appointment.

Does your insurance plan have a deductible and how much is it?

Almost all insurance plans have a deductible that usually begins January 1st of every year. There are many types of plans with different deductibles. It is important to ask about your deductible each year when you enroll in your medical insurance. If you do not know your deductible, we can certainly help you find out if your plan has a deductible and the amount of that deductible, if any.

What is a medical insurance deductible?

A deductible is the amount a patient pays for health care services before a medical insurance company begins to pay for medical services provided to the patient. As an example, Tom has a deductible of $1,000. Tom is responsible for any covered service up to $1000. After the $1,000 has been paid by Tom, he would only be responsible for either a coinsurance or copayment.

If your deductible has not been met, you will need to pay for the services at the time of your appointment. We proudly offer to bill your insurance for the services provided to you in our office.

What is the difference between coinsurance and copayment?

Coinsurance is usually a percentage of the cost of the procedure set by the insurance company. For example, the routine eye exam cost $100 at his eye doctor. Tom may have a coinsurance of 20% of that cost. Thus, Tom would have to pay $20 for his exam.

Copayments are set amounts to be paid by the patient for a specific type of service. For example, Tom’s insurance plan requires him to pay $10 for his routine exam each year.

Sheridan Location

Phone: (307) 673-5177

Gillette Location

Phone: (307) 682-2747

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