Understanding How Your Insurance Works

There are lots of health plans to choose from and they offer a wide variety of coverage options. 

Understanding how Your Insurance works

Generally, the less expensive plans have more restrictions and provide less coverage. You may pay less up front in premiums, but may be required to pay a larger portion of your medical costs.

How Insurance Pays for Care

When you receive care, your insurance company reviews your benefits and determines how much of the bill they will pay and how much you, as the patient, are responsible for.

  • Your doctor sends a bill (called a “claim”) to your insurance company.
  • Your insurance reviews the claim and applies any discounts they’ve negotiated with the doctor.
  • They pay their portion based on your plan benefits.
  • They assign your portion (deductible, co-insurance, or co-pay) for you to pay to the provider.

Your financial responsibility depends on your:

Deductible 

The amount you must pay out-of-pocket each year before insurance begins covering most costs. Some plans have both Individual and Family Deductibles.

Individual Deductible:

This is the amount each person must meet before insurance begins paying for their care.

Example: If your individual deductible is $2,000, you must pay $2,000 for covered services before insurance pays most costs.

Family Deductible:

This applies when you are on a family plan.

The family deductible is the total amount that must be met collectively by all covered members before insurance pays in full for everyone.

Once the family deductible is met, all covered members typically pay only co-insurance or co-pays for the rest of the year.

Example: A family deductible may be $6,000. One family member could meet the entire amount, or several family members’ expenses may add up to meet it.

Co-insurance

A percentage you pay after the deductible is met (e.g., 20%).

Co-payments

Flat amounts due for certain visits or services. The co-pay is usually due at the time of service.

Need Help Understanding Your Plan?

Insurance can be confusing! We will:

✅ Verify your benefits with your insurance company.
✅ Provide a written estimate of what your plan shows you owe.
✅ Answer your questions and discuss payment options if needed

Why We Collect Your Deductible Early?

Many maternity and surgical services apply toward your deductible. 

To avoid unexpected bills later, our office policy is to collect your estimated deductible or co-insurance early in your care.

Prepayment & Refund Policy

Ways to Pay Your Prepayment

Check – No extra charge
Debit card – No extra charge
ACH transfer (electronic bank payment) – No extra charge
Cash – No extra charge
💳 Credit card – A 2.6% processing fee applies. This fee is charged by the credit card company and is non-refundable.

Refunds

If your insurance pays and you are due a refund:

  • Payments made by check, debit, ACH, or cash will be refunded in full.

  • Payments made by credit card will be refunded minus the 2.6% processing fee.

County Obstetrics & Gynecology

STL Leaders in Women’s Healthcare

Board Certified Physician:

Dr. Lawrence V. Boveri

Dr. Stephen A. Boveri

Our Location

1859 Bowles Avenue

Suite 103

Fenton, MO 63026

Our Hours:

Monday:              8:00 – 5:00

Tuesday:            12:00 – 6:00

Wednesday:      12:00 – 6:00

Thursday:            8:00 – 3:00

Friday:                 8:00 – 12:00