Every insurance company has a contracted rate for every service. This means that no matter how much a provider may charge for a service, your insurance and the provider have agreed to a set rate maximum they can be paid.
The amount of money that you need to pay before your insurance starts covering any portion of your bills for certain benefits.
The limit of what you are responsible for paying every year. Once you hit this amount, your insurance company will pay 100% of your medical bills for the rest of the year. Good deal!
A provider that has a contract with your insurance company to charge a contracted amount for their services.
Always check with the provider to make sure they are personally contracted with your insurance company. Just because some providers in a clinic may be contracted, not all are. Call your insurance to verify before your appointment.
The percentage of the bill that you are responsible for, even after you reach your deductible. If you see 20%, that means that you will pay 20% and the insurance company will pay 80%.
With most insurance plans, if a benefit requires you to pay a coinsurance instead of a copay, you will most likely need to meet your deductible before the insurance company will pay for anything. You will pay 100% of the contracted rate until that deductible is met. Then your percentage will kick in.
A set fee that you pay for the care you receive. Depending on your plan, this amount will either be before or after your deductible. Your co-payment will vary between doctor visits, hospital stays, or other care, such as alternative care.
