Helpful Insurance Terms:
Deductible: The dollar amount a patient must pay before his insurance plan will begin to cover his health care costs. Most deductibles must be met each calendar year.
Co-Pay: A payment you make for a health care visit, in addition to the payment made by your insurance company.
Co-Insurance: The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible. Let’s say your health insurance plan’s allowed amount for an office visit is $100 and your coinsurance is 20%. If you’ve paid your deductible: You pay 20% of $100, or $20.
Out-of-Pocket Maximum/Limit: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, co-payments and co-insurance, your plan pays 100-percent of the costs of covered benefits.
Premium: An amount of money that is paid to a health plan by yourself or an employer group in exchange for health care benefits.