Medical, Vision, and Prescription Drugs

Definitions

    • Coinsurance: the percentage of the maximum allowed amount you pay for some covered services.
    • Copayment: the fixed dollar amount you pay for some covered services.
    • Deductible: a fixed dollar amount of covered services you pay in a plan year before your health plan will pay for any remaining covered services during that plan year. 
    • Out of pocket: Deductibles, copayments, and coinsurance for services by providers and facilities within your network count toward your in-network, out-of-pocket expense limit. When your in-network, out-of-pocket expense limit is reached, deductibles, copayments, and coinsurance for in-network services will no longer apply for the rest of the plan year. NOTE: Your health insurance plan, also, has an out-of-network, out-of-pocket expense limit. This is separate from your in-network, out-of-pocket limit.