How much does a visit from GoMED cost?
When you receive your Explanation of Benefits it may show prices that are considerably higher. These medical charges vary and are different from what is allowed by your plan.
Total Visit Costs
Ultimately, the total cost of your visit is driven by how complex the care is as well as any procedures performed, injections given, and what supplies are used. The portion of the total charges that you’ll be responsible for is determined by your insurance company and your individual coverage. Some benefits and plans with higher deductibles might dictate that you pay for the majority of the visit until your deductible is met. With many others, such as POS, PPO, or open access HMO, you might only owe a copay or a percentage of the total charges. With any of these, however, you will never owe more than the allowed amount determined by your insurance company.
Initial Visit Deposit
We collect a $99 deposit for the visit. We will bill your insurance and, after the claim has been adjudicated by your insurance, if you have over paid you will be refunded. If your deductible has not been met or you have a copay, the $99 will be credited towards that amount and you will receive a statement for the remainder.
Example of cost sharing between you and your insurer:
- Co-Insurance: 10%
- Deductible: $2,000
- Out-of-pocket maximum: $5,000
Before Deductible Met
No medical problems. No doctor’s visits. Your plan won’t cover costs until you reach your deductible. Base Visit Cost-$149, you pay-$149. Plan covers -$0.
After Deductible is met
Several Doctor visits and costs have totaled more than $2,000. Your plan will cover a percentage of additional costs until your out-of-pocket maximum has been reached. Base Visit Cost-$149. You Pay- 10%=$14.90. Plan pays 90%= $134.10
After out-of-pocket max is reached
Multiple doctor’s visits or large procedure and total costs of $5,000 are met. Your plan will cover all of the associated costs for the rest of the policy year. Base Visit Cost-$149. You Pay-$0. Plan pays-$149
How We Bill
After GoMED has seen you or your loved ones, here are some things you can expect to receive:
1. Your Explanation of Benefits (EOB)
This is a summary, from your insurance company that will arrive normally within 30-60 days after your visit. It will outline the services rendered and how the visit will be covered by your plan.
2. Bill for Care
Following your EOB, you may receive a bill from GoMED. The amount owed is based on your benefits and determined by your insurance company, as well as the level of care that was provided.
3. Second Attempt Bill for Care
If there is an unpaid billing statement that’s due 45 days after your bill comes, we will send you a friendly reminder of the remaining amount.