ANNUAL DEDUCTIBLE
The flat amount an individual/family will pay each plan year before the plan begins paying for covered services.
TERMS YOU SHOULD KNOW
TERMS YOU SHOULD KNOW
COINSURANCE
The percentage of charges for covered expenses that an insured person is required to pay. In order for coinsurance to apply, the applicable deductible must be met first.
COPAY
The flat amount a person pays toward a doctor’s visit or prescriptions.
IN-NETWORK PROVIDER
In-Network providers agree to accept our contracted network fee. You will generally pay less when using an n-network provider.
OUT-OF-POCKET MAXIMUM
The maximum amount an individual/family will pay out-of-pocket for covered expenses in a plan year. After the Out-Of-Pocket Maximum is reached, the plan will pay 100% of covered charges.
CONSUMER DRIVEN HEALTH PLAN
Also known as a high deductible plan which has higher annual deductibles and out-of-pocket maximums than traditional health plans. The trade off: you pay lower premiums each month.
SPECIALIST VISIT
A visit with a physician that treats or diagnoses a specific symptom or condition
GENERIC PRESCRIPTION
A drug that has been approved by the FDA and derived from a brand name drug
PREFERRED PRESCRIPTION
Brand name drugs or drugs that are either more effective than others in their class or as effective and less costly.
MAIL ORDER PRESCRIPTION
90-day delivery straight to your home, particularly utilized for maintenance medications and results in savings.