Expenses associated with medical services can be confusing. The goal of this page is to make things more clear for your understanding. For specific questions regarding a bill please email email@example.com
Premium: A monthly payment you make to have health insurance. Like a gym membership, you pay the premium each month even if you don’t use it, or you lose coverage. If you’re fortunate enough to have employer-provided insurance, the company picks up all or part of the premium.
Copay: Your copay is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
Deductible: The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your own care out-of-pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.
Coinsurance: Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
Out-of-pocket maximum: The most you could have to pay in one year, out of pocket, for your health care before your insurance covers 100% of the bill.