COVERED DOES NOT MEAN ‘PAID IN FULL’
Deductible
This is the amount you must pay for certain covered services before your health insurance begins to pay.
- Example: If your deductible is $2,000, your insurance will not pay for any service to which the deductible applies until you have paid $2,000. Once you have satisfied your deductible, then your insurance company will begin paying your claims.
Coinsurance
The percentage of the bill you pay for a covered service.
- Example: If you have a 20% coinsurance, which applies to certain services, then you will owe 20% of your insurance plan’s contracted rate. If the allowed amount or contracted rate for a service is $100, you owe $20. The insurance company will pay the rest.
Copayment
The set dollar amount you pay for a covered product or service.
- Example: If you have a $20 copay for primary care physician visits and $40 copay for specialist visits, then you will have to pay $20 every time you see your PCP and $40 every time you see a specialist.
All cost share amounts will be collected at the time of service. Your insurance plan is a contract between you and your insurance company. Please familiarize yourself with your plan’s specific cost share responsibilities to know when and where they apply.