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Understanding Your Health Plan

Healthcare doesn’t have to be confusing. We have the information and tools you need to understand all those strange-sounding terms – and to find out what your plan includes, what services it covers and how much things will cost you.

Scroll down to discover helpful resources made just for you. With this information in hand, you’ll feel newly empowered to take the best care of your health. And remember, we’re always just a phone call away. If you have any questions, you can reach us at the number on the back of your health plan ID card.

Common Terms and Costs Video

Common Terms and Costs

We know health plans can be confusing – especially all those strange-sounding terms and knowing how much you might have to pay for certain things. Here’s a quick list of key terms to know. For more about these – or if you have any questions – give us a call at the number on the back of your health plan ID card. We’re always here to help.

  • Premium: The monthly amount you pay to be on our plan.
  • Benefits: The healthcare services your plan covers. These can include doctor visits, tests, yearly physicals, surgeries and more.
  • Out-of-Pocket Costs: Although your plan covers these benefits, you still have to pay some or all of the costs for many of them. Out-of-pocket costs are the costs you (rather than your health plan) pay. These can include:
    • Deductible: A set amount you pay for your care and services, before your plan helps you split costs for the rest of the year.**
    • Copay: A set dollar amount you pay for a healthcare benefit (like a doctor visit).
    • Coinsurance: Instead of a set dollar amount, you pay a percent of the total cost (for a healthcare benefit).
  • Out-of-Pocket Maximum: After you pay this amount in combined out-of-pocket costs throughout the year, your plan pays 100% of covered expenses for the rest of the year.
    ** You no longer have to pay copays or coinsurance, just your monthly premium.
graphic version of all the above text

More Resources

*All plans are different. Call the number on the back of your health plan ID card for information about your plan’s specific benefits, coverage, costs and maximums.

**Not all plans cover a full year, and not all begin in January and end in December. Call the number on the back of your health plan ID card for information about your plan’s specific benefit period.