Insurance
Understanding Your Insurance Coverage
Navigating health insurance can feel overwhelming, especially when plans use terms that may be unfamiliar or vary from one provider to another. To help you better understand out of pocket costs and what to expect when accessing care, we’ve defined some of the most common insurance terms below. These explanations are general guidelines, any specific benefits, copays, deductibles, and coverage details may differ. For the most accurate information about your plan, always contact your insurance company directly.
Insurance Terms
These definitions apply to the most common insurance coverages. To understand your plan benefits specifically, contact your insurance company for details.
- In-Network: Providers who have contracted with an insurance company at pre-negotiated rates to provide services to plan members. Anyone outside that network is considered out-of-network, so discounted rates will not apply.
- Copayment (Copay): A flat dollar amount specified by your insurance plan to be paid at a visit. That amount may vary by visit type or service.
- Deductible: The dollar amount that must be paid out-of-pocket before an insurance company begins to pay for services. This amount resets at the beginning of a new benefit period (typically annually).
- Out-of-Pocket: Expenses that must be paid depending on your insurance plan. Costs vary by plan, and there’s usually a maximum out-of-pocket (MOOP) cost.
- Coinsurance: The percentage you pay to share the cost of covered services after your deductible has been met.
- Non-Covered Services: Insurance plans specify which services are covered. Any service received outside of that coverage must be paid out-of-pocket.
