Question about copay/coinsurance for Atlas America

[paccha9999]

I am planning to buy Atlas america for my mother who will be visiting shortly. The plan says that the coverage is 80/20 co-insurance for the first 5000$, but that is waived if she visits a doctor/hospital within the ppo network. So my question is:

1. If I visit a doc or hospital within the network, i don't pay anything out of pocket as long as the insurance covers it?

2. Is copay/coinsurance the same? Suppose i visit a doctor in the ppo network, i don't pay any copay for the visit?

[insubuy]

Copay is the fixed amount you pay when you visit a doctor, for example, $10 for general physician, $25 for specialist and so on.

There is no concept of copay in short term plans. Instead, after you pay the deductible, you pay the coinsurance up to certain amount and then the insurance pays the rest.

In Atlas America Insurance, after you pay the deductible, as long as you visit the providers in the network and they bill directly, you are covered 100% up to the policy maximum. Otherwise, after the deductible, it will cover 80/20 for first $5,000 and then 100% up to the policy maximum.

100% coinsurance (or coinsurance waived) means you don't pay anything towards the coinsurance.

You can purchase Atlas America Insurance online.

I hope that answers your questions.

If you have any other questions, please feel free to contact us at any time or post them here.