Insurance Education Corner

Understanding Deductibles, Copays, and Out-of-Pocket Maximums

Health insurance plans include several cost-sharing features that can sometimes be confusing. Understanding a few key terms can help you better manage your healthcare costs.

Deductible:
This is the amount you must pay for covered healthcare services before your insurance plan begins paying for most services.

Copay:
A copay is a fixed amount you pay for certain services, such as a doctor visit or prescription medication.

Coinsurance:
After you meet your deductible, coinsurance is the percentage of the cost you may share with your insurance plan for covered services.

Out-of-Pocket Maximum:
This is the most you will pay during the year for covered healthcare services. Once you reach this limit, your insurance plan typically pays 100% of covered services for the rest of the year.

Understanding how these pieces work together can help you choose a plan that fits both your healthcare needs and your budget.

If you ever have questions about how your coverage works, the MyCarePro team is always available to help explain your benefits.