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  • Out-of-pocket Maximum

    The out-of-pocket maximum is the total amount you are required to spend for medical care in a year. This usually includes the total amount spent on your deductible, coinsurance and/or co-pays; but not the premium and in some cases, not...

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  • Co-pay

    A co-pay is the flat fee you have to pay for a service, such as a doctor’s visit or a prescription. If you have a $15 co-pay, you will pay $15 for a doctor’s visit.

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  • Co-insurance

    The amount of cost sharing between you and your insurance company. If you have a 80%/20% co-insurance, this means that when you receive care, the insurance company pays 80% of the cost and you pay the other 20%.

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  • Deductible

    A deductible is the amount you pay for care before your insurance kicks in. For example, if you have a $1,000 deductible, you will pay $1,000 before your insurance covers health care costs. There can be another deductible for a...

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  • Premium

    A premium is the amount you pay, typically per month, to maintain your insurance. If you have a $200 premium, you will pay $200 a month to have health insurance.

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