What Is First Dollar Coverage in Health Insurance?

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First dollar coverage in health insurance means that your insurance covers health care expenses without copayments or deductibles having to be paid first. It pays expenses beginning with the first dollar charged for health care or hospitalization depending on the type of policy purchased.


Base or Basic Plans

First dollar coverage plans are also referred to as base or basic plans. For example, basic hospital, basic medical or basic surgical plans.

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Higher Premiums

First dollar or base plans are not common and the premiums for such plans are generally more expensive than for a plan with deductibles and copayments.


Low Limits

First dollar plans generally have low limits on how much first dollar coverage the insurance company will pay for medical treatment or health care before deductibles and copayments are required. Some plans offer $250 or $300 per year for health care and $500 per day for hospitalization, but this figure varies widely depending on the plan purchased.


PPOs and HMOs

There are Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans that can be purchased as first dollar or base plans.


Limits Per Year or Event

First dollar PPO and HMO plans may or may not allow unused first dollar limits to be held over into the following year. This varies depending on the insurance company and plan selected.


Hospital Expense Plan

A base or first dollar hospital expense plan will usually cover hospital charges, but this may not include giving birth to a child.



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