Helpful insurance terms
Copay – a flat fee you pay whenever you use certain medical services, like a doctor visit.
Deductible – the amount you pay in a calendar year (January - December) before your medical insurance begins paying deductible-eligible claims.
Coinsurance – the percentage of covered medical expenses you continue to pay after you’ve met your deductible and before you reach your out of pocket maximum for the benefit year.
Out of pocket maximum – the most you will pay during the calendar year for covered expenses. This includes copays, deductibles, coinsurance, and prescription drugs.
Balance billing – the amount you are billed by out-of network providers to make up the difference between the amount they charge and what insurance reimburses. This amount is in addition to, and does not count toward your out of pocket maximum.
Benefit year - September through August each year.