Help me understand my insurance plan
So I'm considering changing employers, and with that insurance. I've been in the U.S. for less than a year and feel like I don't understand something fundamental about insurance. I have a United Oxford OHI EPO insurance with the following stats:
PCP: $30
Spec: $80
Ded IND/FAM: $3750/$7600
OOPM IND/FAM: $9100/$18200
What I understand: When I go to a family doctor, I pay $30. When I got to a specialist $80.
What I don't understand: I'm taking a medicine that costs $20K. That's above my deductible of $3750. So by that logic, I should pay $20,000 – $3,750, right? But, my bill was $200 and lowered by calling the pharmacy down to $5. This is great, but I don't understand the math. This makes it difficult for me to know whether my new insurance will be as good as this.
Yesterday I went to pick up some medicine from CVS. My pills were $3.25. Why? What is the math being done here? I always understood that I pay the amount up until the deductible, but so far, that hasn't been the case. Is it completely at the insurance companies discretion?
I'd appreciate any help here!
submitted by /u/Cold_Nobody_9685
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