insurance

Capital Ob/Gyn – Insurance Information

General

If you are a member of an insurance plan, you have entered into a legal and contractual agreement between you and your insurance company regarding the terms of your coverage. Capital Ob/Gyn Associates of Texas is pleased to be a preferred in-network provider with most major insurance companies. This means that we, too, are contractually obligated to abide by the terms of your agreement and ours. As a courtesy to our patients, Capital Ob/Gyn Associates of Texas will try to contact your insurance carrier to help you determine your deductibles, co-insurance payments and co-pays. Both patient and provider are legally obligated as members of an insurance plan to abide by the terms of that plan.

Unfortunately, many health benefits are being trimmed while deductibles and co-pays are increasing. Capital Ob/Gyn Associates of Texas accepts cash, check, VISA, Mastercard and Discover for your convenience. If you are an obstetrical patient you may inquire about establishing a payment plan for maternity services.

Insurance Plans Accepted

Our practice is in network with United Healthcare (UHC), Blue Cross Blue Shield (BCBS), Aetna, Cigna, Coventry Health, Galaxy Healthcare, Great West, Healthsmart, Humana, Medicaid (TMHP) for OB, Medicare, Medicaid (BCBSMD), Chip, Mega Life, Multi Plan, PHCS, Seton EPN for gyn, Texas True Choice, Tricare, WebTA. Don’t see your plan listed? Please contact our office as we are in network with additional plans not listed.

Deductible

The deductible is a specific fixed dollar amount that your insurance company requires you to pay on claims before the insurance company will pay for covered services. Deductibles vary from $0.00 to $5,000.00 or even higher. The deductible is an annual amount per your insurance calendar year. This does not always correlate with a January 1 calendar year.

Co-insurance

A co-insurance is the percentage of medical charges that your insurance company requires you to pay after you have met your deductible. The more common co-insurance amounts are 80/20, in which you are required to pay 20% of the allowable medical charge, and 90/10, in which you are required to pay 10% of the allowable medical charge.

Co-pay

A co-pay is the flat amount your insurance company requires you to pay at the time of medical services or to receive a medical prescription. Each insurance plan establishes these fees upfront. Many women consider their ob/gyn physician to be their primary care physician. However, ob/gyn physicians are surgical specialists, and most insurance companies require that you pay a specialist co-pay for your office visit.