Tuesday 4 March 2014

Co-Payment

....Also known  as "Copay"


A fixed dollar amount you pay for certain types of care.

-       You might pay a $20 for a chiropractor’s visit and the insurance company will reimburse the rest.   Plans with higher premiums generally have lower copays, and vice versa. 

      Here is what you get with Blue Cross Insurance, and that is why in my professional opinion, they have the best offer on the Canadian market at this point, compared to Manulife and Sunlife.
   
     ** What does a $50 Maximum Co-payment Per Prescription mean....to a client...?

The drug module under the Options and Options Plus personal health plans can help keep your costs down. It has no overall maximum and a maximum co-payment of $50 per prescription. The most you’ll ever pay for any one prescription is $50.

For example:

The $50 maximum co-payment per prescription could save you more than $3,500 in one year alone over a conventional 20% co-payment plan.  Overall, the Options Plus plan could save you more than $20,000 in one year.

Example of James (one of our client) living with Psoriatic arthritis:

Cost of medication:"Enbrel" 
  • $1,733.69 (per month)
  • $20,804.28 (per year)
Cost to James with 20% co-payment:
  • $346.74 (per month)
  • $4,160.86 (per year)
Cost to James with an Options or Options Plus plan
  • only $50 per month = $600 per year.

So on a regular individual or group coverage, it could of cost James over $20,000 compared to $600.