Whats the difference between a deductible, a copayment and out-of-pocket expenses?
Deductible. The amount the plan participant is responsible for paying each year before the plan will make payment for eligible benefits. Copayment. The plan participant pays a specified amount for a specified service, such as $20 for an office visit. Usually the plan participant is responsible for payments at the time services are rendered. Out-of-pocket expenses. The portion of health service payments required to be paid by the plan participant which may include deductibles, copayments and coinsurance, before the plan will pay at a higher benefit level.
Related Questions
- Can you clarify the difference between the Annual Deductible vs. Out-of-Pocket Maximum in the POS Out-of-Network coverage?
- Does the copayment apply to the deductible in the POS plan, as well as to the Out-of-Pocket maximum?
- Are preventive care expenses in excess of $500 applied to the deductible and the out-of-pocket max?
