In-Network Insurance | Medical Equipment, Supplies, and Services

What is a Deductible?

A deductible is a fixed yearly dollar amount that you pay out of pocket before your insurance begins to pay. Not all insurance plans have deductibles.

What is Coinsurance?

Coinsurance is the percentage of medical costs the policyholder pays after a deductible has been met. For example, Ron has oxygen equipment and sees his doctor regularly. Ron’s annual deductible is $1,000. After Ron’s deductible has been met, his insurance plan pays 90% of the charges, making Ron responsible for remaining 10%. This 10% is Ron’s coinsurance.

What is Secondary Insurance?

Secondary insurance is a separate policy that can help pay for your coinsurance payment. For instance, if Ron had a secondary insurance policy, it would pay for most or all of the 10% payment Ron is responsible for after his primary policy paid the 90%.

What is Prior Authorization?

Some insurance plans require a prior authorization before delivery of durable medical and respiratory equipment. The Prism Health Care Service customer services team is trained to work with your insurance plan to obtain the required documents to process the prior authorization request. For rental equipment, it is important that you follow up with your treating physician to ensure there is not a delay in the authorization process. Most insurance companies provide a prior authorization ranging from 1-3 months. Prism Health Care Services will work with your insurance plan to obtain an extension on your prior authorization. If you have not seen your treating physician since the start of the rental equipment period, it is likely your insurance carrier will not approve extending the prior authorization period. Insurance plan prior authorization can take up to 5 business days.