Here's a few insurance definitions found on your benefits .. hopefully this will help explain them !
DEDUCTIBLE: The amount you owe for health care services your health insurance covers before your health insurance begins to pay. For example, if your deductible is $1000, your plan won't pay anything until you've met your deductible for covered health care services (subject to the deductible). The deductible does not apply to all services.
CO-PAYMENT: A fixed amount (for example $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of service you receive.
CO-INSURANCE: Your share of the costs of a covered health care service, calculated as a percent (20%) of the allowed amount for the service. YOU pay co-insurance PLUS any deductibles you owe. For example, if the health insurance or plan's allowed amount for an office visit is $100 and you've met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.
OUT OF POCKET LIMIT: The most you pay during a policy period (usually a year) before your health insurance begins to pay 100% of the allowed amount. This limit never includes your premium, balanced-billed charges, or health care your health insurance does not cover. Typically your co-payments, deductibles, co-insurance payments, and out-of-network payments go toward this limit.
Check back next week for more definitions!
*Source OMB Control #s 1545-2229, 1210-0147, and 0-938-1146