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We understand how important it is to
find the right plan to fit your needs
and we're happy to educate you every step of the way.
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Please contact us if you cannot find an answer to your question.
A deductible is a specified amount of money that an insured must pay before an insurance company will begin paying a claim.
An out-of-pocket maximum is a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year. After reaching your out-of-pocket maximum, insurance pays 100% for eligible expense.
Money paid toward your deductible also goes towards your Out of Pocket Maximum.
The percentage of the cost that insurance will pay toward medical expenses after you've reached your deductible. This is what insurance pays in the stage between reaching your deductible and out-of-pocket maximum. An insurance plan's coinsurance can range from 50%- 100%.
A copay is a fixed amount you're expected to pay for certain medical services. The copayment made applies to your out-of-pocket maximum (but not your annual medical deductible).
This is an additional amount you may owe for a specific service (such as an ER Visit), per occurrence. This charge doesn't apply to your annual medical deductible. Your per occurrence deductible will apply to your out-of-pocket maximum.