However, Bayer insists the out-of-pocket expense
for the majority of patients will be $20 or less.
Nearly two-thirds (65 percent) say if they had an unexpected out-of-pocket expense
, they could afford less than $1,000.
The average adjusted per claim out-of-pocket expense
for oral contraceptive pills fell from $33.58 in June 2012 to $19.84 in June 2013, after the mandate took effect for most private health plans.
"For customers making a claim for out-of-pocket expense
, we will launch a comprehensive process later this week so anyone impacted will fully understand how to progress any claims they may have as a result of this issue."
If Congress specifies exactly what an insurer may charge a consumer for certain procedures or whether certain procedures will be covered without any out-of-pocket expense
, insurers will be left with little room to make private business decisions on coverage, revenue, or payment schemes.
Under one option, employees would have to cover their first $600 of medical bills each year, then would be responsible for 10 percent of their additional medical costs until they reach a maximum total out-of-pocket expense
of $1,500, after which the state plan would cover the rest.
FCAA's only out-of-pocket expense
was the $50 permit fee required by the City of Jacksonville Beach.
There are different ways to solve this out-of-pocket expense
dilemma: Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), and Health Reimbursement Accounts (HRAs).
"People were anxious about the immediate impact of the out-of-pocket expense
," Yoder says.
The intent at most schools is for student-athletes to have no out-of-pocket expense
TABLE 1: THE LAW MEDICARE PART D BENEFITS Out-of-Pocket Expense
Description $250 Deductible $500 25% of the next $2,000 in charges $2,850 100% of the next $2,850 in charges $3,600 Total based on $5,100 in charges Source: Illustration of Part D benefits by Phyllis Shelton, LTC Consultants, Hendersonville, Tenn.
If a patient gets outside help to pay for medications while she's in the donut hole, that financial help may count as an out-of-pocket expense
, and once total drug costs reach the "catastrophic" level, Part D will pay for 95% of further costs.