Health Insurance Definitions
The way an insurance plan shares costs with you. For example, when you receive care, the medical plan pays 80% coinsurance for eligible in-network services, and you pay 20% coinsurance.
A flat dollar amount you pay every time for certain services such as physician office visits. Copayments do count toward the deductible and the out-of-pocket maximum.
The amount you must pay for eligible services before the plan begins paying anything for the policy year. The deductible does count toward the out-of-pocket maximum.
Doctors and other healthcare providers who agree to charge plan members a lower, negotiated cost for healthcare services.
What you pay when you receive care, including copayments, amounts you pay toward the deductible and your share of coinsurance.
The amount you must pay through coinsurance before the plan pays 100% of the cost for your eligible services for the rest of the policy year. In other words, once you reach the out-of-pocket maximum, the plan pays 100% of your eligible costs (excluding copayments).
The amount you pay for coverage. The premium cost is charged to your bursar's account.