[Oneill474]

My wife has health insurance. The doctor visit is co-pay $20.00 Specialist is co-pay $40.00 when it comes to the hospital
Is has a $1,000 deductible Plus $200.00 a day for 5 days. The out of pocket expense total is $2,000. The agent told
Me that is $3,000 all together before it pays 100%.
So if she when to hospital for 5 days I paid $2,000/ the insurance still would not kick in. because I am $1,000
Short of the $3,000 out of pocket amount. Is this correct?

[ScottGem]

Doesn't seem to be. If the policy states there is a max out of pocket for a hospital visit of $2K, then that is all you should have to pay for the hospital services. However, there may be other costs that are not part of the hospital bill.

[Fr_Chuck]

The thing you are not looking at is does it pay a percentage prior to paying 100 percent like 50 or 80 percent of the lower amounts that is over the co/pay but less than full deductable.

For example, I have a 300 dollar payment at the ER, my insurance then pays 80 percent till I have paid a total of 3000, then they pay 100 percent.

You will need to read what the actual policy says, not what the agent said,

Sadly many agents
1. lie
2.don't know their own policy
3. are confused