If you are on a High Deductible health plan:
Your insurance plan requires you to pay for all your medical expenses out-of-pocket until you meet the deductible set by your plan every year
The dollar amount that you have to pay before your insurance “kicks-in” is variable and depends on your plan (this dollar amount is called your deductible).
For many plans, the deductible can be greater than $5,000 for individuals and $10,000 for families i.e. you have to pay this amount out of pocket before insurance starts covering your cost of medical care.
After you have met your deductible, you may still have a copay or co-insurance (e.g. you may be required to pay a percentage of the total bill) till you reach your “out-of-pocket max.”
After you reach your “out-of-pocket max”, insurance typically covers all costs provided it is a covered medical benefit e.g. insurance will not cover cosmetic procedure even if you meet your ou-of-pocket-max.
If you have any questions about your plan, please reach out to your insurance company.
The video below was made by Consumer Reports and provides a good explanation on how High Deductible Health Plans work.
How much does a medical office visit Cost?
Medical visit payment rates are different between different insurance companies (and sometimes within different plans in the same insurance company)
A rough guide is:
New Patient Office Visit: $200 - $450 depending on how much time is spent on evaluation and/or how many medical conditions are addressed.
Subsequent Office Visits: $75 - $300 depending on how much time is spent on evaluation and/or the number of medical conditions being addressed.
Any tests performed during the visit are ADDITIONAL cost according to your insurance plan.
Most insurances will cover Preventative Visit without deductible or copay - e.g. Annual Physical or Medicare Annual Wellness Visit (medical problems are not evaluated or assessed during this visit).
To understand the difference between a Annual Preventative/Physical visit vs a medical visit please click on the button below.
(Please note that the cost of office visit will be similar irrespective of where, or by which physician you are being seen.)
If you are interested in paying out of pocket (i.e. Avanta Clinic will not bill your insurance), you can view our self pay rates on our dedicated webpage.