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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. |
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