A PREMIUM is the amount you pay for insurance, using pre-tax or post-tax
dollars.
Copay
A COPAYMENT (COPAY) is a fixed amount you pay for health care services or
prescription drugs.
Deductible
A DEDUCTIBLE is the amount you pay before your insurance begins covering
certain services such as hospitalization or outpatient surgery.
Coinsurance
COINSURANCE is the amount you pay, as a percentage of the cost of your
allowed services, after you reach the deductible until you reach the plan’s out-ofpocket maximum.
Allowable Charge
An ALLOWABLE CHARGE is the dollar amount typically considered payment in
full by an insurance company and an associated network of health care
providers.
Out of Pocket Maximum
An OUT-OF-POCKET MAXIMUM is the most you pay per Plan Year for
health care expenses, including prescription drugs. Once this limit is met, the
plan pays 100% for the remainder of the Plan Year.