What Is First Dollar Coverage in Health Insurance?

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First dollar coverage refers to benefits payable by a health insurance plan without the member incurring an upfront cost. Find out about first dollar coverage in health insurance with help from the president of The Stratford Financial Group, Inc. in this free video clip.

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Hello, I'm Jeffrey Ingalls, president of Stratford Financial Group, and Stratford Employer Services in Wayne, New Jersey, and right now we're going to talk about, what is first dollar coverage in health insurance? First dollar coverage or first dollar benefits refer to benefits payable by a health or medical insurance plan without the member or insured first incurring an upfront cost, most commonly in the form of a deductible. First dollar benefits are often found in the in-network benefits of a managed care health insurance program, such as a PPO, point-of-service plan, EPO, or HMO. These plans often offer first dollar in-network benefits in the form of low co-pays and zero dollar deductibles, to steer their members to the participating list of providers. In that regard, an example of a first dollar benefit would be a PPO plan, which would cover an in-network office visit, subject to only a $20 co-pay. Conversely, an example of a plan or instance without first dollar benefits would be a member having to satisfy a thousand dollar deductible before out-of-network benefits are payable under a point-of-service plan. First dollar benefits are often blamed for the spike in medical costs, as well as ever increasing premiums. This is something high deductible health plans sought to remedy by adding an upfront deductible in all of their plan designs. My name is Jeffrey Ingalls. I'm the president of Stratford Financial Group, and Stratford Employer Services in Wayne, New Jersey. We can be found online at www.stratfordlink.com, and you just watched, what is first dollar coverage in health insurance? Thank you.

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