Insurance 101.

Deductible

An annual deductible is a set amount you must pay out of pocket for healthcare expenses before your health plan starts covering costs. Until you meet this deductible, you are responsible for paying the full price or a specified amount for medical services. Once the deductible is met, your health plan benefits will take effect.

Co-Pays

• Insurance co-pays are fixed, predetermined amounts you pay out of pocket for specific healthcare services or medications at the time of service.
• Co-insurance refers to the split between insurance and insured (e.g. 80/20% where insurance will cover 80% and you are responsible for 20% until either deductible is met or max-out-of-pocket is met).

Networks

There are 3 kinds of health insurance networks.

• PPO- Nationwide Coverage/No referrals needed for specialist visits.
• EPO- Nationwide coverage/Referrals needed for specialist visits.
• HMO- Statewide coverage/Referrals needed for specialist visits.