Frequently Asked Questions
What are deductibles, co-pays, premiums, coinsurance, and maximum out of pocket?
Premium: The monthly fee you pay for a health care plan’s services.
Deductible: The amount you have to pay yourself before the health insurance company will start paying for services. (If you had a $200 X-ray bill, and your deductible was $500, you’d apply that cost to the deductible, and only have to spend $300 more before your insurance kicks in.)
Coinsurance: The part of the bill you’re responsible for when you use medical services (usually 20%). Your health insurance plan picks up the other 80%.
Co-pay: A small, flat fee you pay for services, such as $10 for a doctor visit. (If you have co-pays, you don’t pay coinsurance.)
Maximum out of pocket: A cap on your yearly expenses that protects you from the high costs of a serious illness or operation.