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Insurance Terms

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Insurance Terms* Some insurance terms may be unfamiliar to you. Here's a short glossary. Benefit amount: The payment you receive for covered expenses up to the percentage covered by our plan. This is paid after you pay the deductible. Coinsurance: Your share of the cost of your medical/dental coverage. Covered charges: Those charges which are considered medically necessary and which are within the terms and conditions of your benefit plan. To be covered, all medical and surgical services, supplies and treatment must be considered medically necessary and provided on the recommendation and approval of a qualified provider. Deductible: The portion of your medical expenses that you pay before benefits can be paid. Out-of-pocket expense: The amount you pay for your health care services. Individual plans have different amounts of out-of-pocket expense limits. When this limit has been met, the plan will usually pay 100% of remaining covered medical expenses for the calendar year. Please check your booklet for out-of-pocket limits and requirements. Reasonable and customary charges (R&C): Charges calculated within the usual range of charges for similar services to people who have similar medical conditions in the location. * Please refer to your particular policy for a more complete description of Insurance terms and their meanings.

Insurance Terms

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