<prompt> Human: i didnt pay two bills last year. This was probably financially extremely stupid i know.1 submitted a disconnect notice for my apartments gas upon moving out. The gas company continued to bill me for gas.I submitted another disconnect notice and told them im not paying the bill because. Every month I recieve a bill. I submit a new disconnect notice. And i contact customer service saying im not paying and if you attempt to harm my credit i will take you to courtno idea how viable that is2. Went to the doctor and paid copay. They sent me a full 200 dollar bill a few months later. The doctor only had referred me to a specialist and said she couldnt help she is an emergency doc in the box. I emailed them back saying i paid my copay in full, please contact to my isnurance company for the unpaid amount.They sent me to some collection agency. But, I do not see this ever appearing on my credit at all. what gives?  <response>: I dont have anything to add on the debt collection aspect of this question, but I do want to reach out to describe how health insurance in the US works because referring to the co-pay and deferring back to your insurance company indicates a pretty significant misunderstanding.There are 4 critical numbers you need to understand for what you pay for your healthcare in the context of health insurance.1. The premium: this is the monthly payment you make to your health insurer to provide you coverage a promise to pay for healthcare under the terms of the policy2. The Co-Pay. This is a nominal dollar amount that your insurance policy says you must pay for providers at time of service. The co-pay has almost no relationship to the actual costs for services rendered. Doctors are extremely highly trained with exceptionally expensive schooling, run offices with many staff people, and carry massive liability insurance policies. Most people make the mistake thinking their 102050 co-pay paid for the visit and their insurance is screwing them with another bill. This is simply false. A co-pay serves 2 purposes: 1 it shows the patient that money has changed hands for this transaction, which is used as an indicator to the insured that the service has a cost and value; 2 it pays the doctors office for the 10 minutes of time it takes a billing person to submit the real claim to the insurance company3. The deductible: this is a set dollar amount that your insurer says is your responsibility before they start paying for anything, with the frequent exception of preventative services e.g. annual physical, vaccinations or specialist visits with a referral, as laid out in the policy. Until you satisfy your deductible, your insurer will not pay for many things. If I have a 2000 deductible, Ill have to pay out 2000 on ambulance rides and ER visits and a broken leg, before the insurance company chips in for my heart attack. Co-pays are usually exempt from the deductible.4. Co-Insurance. This is by far the most confusing and least well-understood aspect of health insurance. A co-insurance rate is a share of cost that the patient must pay after their deductible is satisfied. In the example above, I probably have a 20 co-insurance rate, so even after satisfying my 2000 deductible I have to pay 20 of the 15,000 bill for my heart attack another 3000. The insurance company pays the other 80. Co-insurance usually phases out when an annual maximum out-of-pocket clause in the policy hits, that says you only ever have to pay XX out of pocket, except co-pays. If my maximum out of pocket clause was 4,000 in the above example, I would have only paid my 2000 deductible and then 2,000 of my co-insurance before hitting the maximum and having the insurance company pick up everything under catastrophic coverage.This primer leaves out a lot of detail. Ultimately, everything in your health plan is governed by specific terms laid out in your policy. Even within insurance companies, theyll frequently have many types of policies: Preferred Provider Organization PPO plans are different from Health Maintenance Organization HMO plans are different from Fee For Service FFS plans in the level of plan control.The reason I laid this all out is to explain the reason the doctors office billed you 200. Your co-pay didnt pay for the service, didnt even come close, and your insurer did not cover the bill for a specific reason that would have been indicated to you on an Explanation of Benefits document that looks a hell of a lot like a bill but isnt one. Most likely reasons for the situation you describe would be going to a specialist without a proper primary care referral on an HMO plan, or a visit that falls under your deductible rather than insured services.The proper course of action in this type of situation is to go to your insurer to appeal the denied service. The reason the doctors office billed you is because they already went to the insurer and didnt get paid, so telling them to go back to that well is a non-starter. 