On National Insurance Awareness Day, we would like to share some things with you to help you understand insurance plans.   

Commonly used terms:

COPAY – A fixed amount you pay for a particular service, typically for an office visit.

DEDUCTIBLE – The amount you must pay before your insurance begins to contribute to the cost of services.

COINSURANCE – The percentage you are responsible to pay after your deductible is met. 

OUT OF POCKET MAX – The most you are responsible to pay per benefit year.

OPEN ENROLLMENT – The time of year that you are able to make changes to your insurance plan without a qualifying event.

QUALIFYING EVENT – A life event that allows you to make a change to your insurance plan that is outside open enrollment.  Examples: Marriage, Birth of Child, Change of job, Death, Divorce, etc.

IN NETWORK – Providers who have a contract with an insurance company to provide services at a negotiated cost.

OUT OF NETWORK – The provider does not have a contract with an insurance company.  This could result in higher out of pocket costs.

Understanding your insurance plan will help you know how much money you could spend each year in medical services.  This is extremely important so that if you have planned services, you can be prepared financially.

If you have any questions on an upcoming test or procedure, you can always call our Financial Counselor at 920.749.4000 to help understand your out of pocket costs.