Contact Center Industry News

TMCNet:  New Year, New Annual Deductible: New Tool from Computes Patient's Share of Medical Costs

[January 31, 2014]

New Year, New Annual Deductible: New Tool from Computes Patient's Share of Medical Costs

PROVIDENCE, R.I. --(Business Wire)--

The new year meant the start of a new annual deductible for most patients with health insurance. For many individuals, particularly those with health plans purchased through the new Obamacare insurance exchanges, deductibles are higher and benefits have changed, making it harder to determine their out-of-pocket costs for medical procedures, according to

"Many patients who receive medical care in January or February often have to pay 100% of the cost, because the balance in their health insurance annual deductible has rolled back to zero. In deciding when or where to receive medical procedures, patients naturally want to know their out-of-pocket costs will be. Our free online calculator empowers patients to have an informed conversation with their physicians about the cost of treatment," said Dr. Weintrub, a reired physician, entrepreneur and founder of

According to the Kaiser Family Foundation, medical insurance deductibles for plans on the federal exchange average $3,000, and those for the least expensive, bronze plans average $5,082. The Obamacare insurance plans are available at Deductibles for the 165 million people covered by employer-sponsored insurance plans average $1,135 a year in 2013, according to a separate Kaiser study.

According to Dr. Weintrub, the three most important factors in when and where patients decide to receive care are "urgency, quality of care and price."

"When patients know what their out-of-pocket costs will be, they can make informed decisions. While some conditions require immediate treatments, many elective procedures can be postponed until later in the year when an individual has met their deductible," said Dr. Weintrub.

As explained on the Coverage Calculator site, patients discuss potential fees with their physician and obtain co-payment, deductible and co-insurance coverage data from health plans. Using this data, Coverage Calculator "does the math" and determines the out-of-pocket cost.

Determining out-of-pocket costs in advance can lead to improved patient satisfaction and faster physician payment. "Physician practice management experts report that most patients are willing and able to pay their share of the bill in the office, if it is explained to them," said Dr. Weintrub.

CoverageCalculator Inc. is an independent, for profit corporation based in Providence, R.I.

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