Insurance
Questions To Ask Your Health Insurance Company
Have your insurance card out when you call you will be asked to provide your member ID and other identifying information.
Out Of Network Benefits Questions
How do I submit claims for out-of-network reimbursement?
Understanding You Benefits
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Annual deductible
The amount you pay each plan year before the insurance company starts paying its share of the costs. If the deductible is $2,000, then you would be responsible for paying the first $2,000 in health care you receive each year, after which the insurance company would start paying its share.
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Copay/Copayment
A fixed, up-front amount you pay each time you receive care when that care is subject to a copay. A copay of $30 might be applicable to a doctor visit, after which the insurance company picks up the rest. Plans with higher premiums generally have lower copays, and vice versa. Plans that do not have copays typically use other methods of cost sharing.
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Coinsurance
A percentage of the cost of your medical care. For example an individual therapy session that costs $160, you might pay 20 percent ($32). Your insurance company will pay the other 80 percent ($128). Plans with higher premiums typically have less coinsurance.
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Annual Out-Of-Pocket Maximum
The most cost-sharing you will be responsible for in a year. It is the total of your deductible, copays, and coinsurance (but does not include your premiums). Once you hit this limit, the insurance company will pick up 100 percent of your covered costs for the remainder of the plan year.