It is important you understand how your insurance pays for the services that are provided to you the patient. Before we start it is important to know some key terms that apply to health insurance.
The amount you pay your insurance company monthly or yearly for your coverage.
This is the money you must pay out of your own pocket before your coverage starts paying. Often this is variable depending on the cost of your insurance. Some may pay as much as $5,000 a year before the insurance covers.
This is the amount of money you will owe to your provider once the deductibles are met. This is usually a pre-determined percentage of the bill such as 15 or 20%.
This plan is like co-insurance but you must make this payment at the time you receive care. Most co-pays are around $25-50 per office visit.
This is the most you would have to pay in a year before the insurance starts paying all expenses.
These are the providers that are covered within the insurance plan.
These are the providers not in your plan. They are usually more expensive than in-network providers.
If you are covered by more than on health plan.