Coverage for these plans begins on Jan 1, 2020
Download your Evidence of Coverage for Deductible Plans.
How do out-of-pocket costs work?
A copay (or copayment) is the flat fee that you pay each time you go to your doctor or fill a prescription. For example, if you have the flu and go see your doctor, or you need a refill of your diabetes medication, the amount you pay for that visit or medicine is your copay.
A deductible is the amount you pay each year for most eligible medical services or medications before your health plan begins to share in the cost of covered services. For example, if your annual deductible is $4,000, you'll need to pay the first $4,000 of your total eligible medical costs before your plan begins to share costs.
Coinsurance is the portion of medical costs you pay after your deductible has been met. Coinsurance is a way of saying that you and your insurance plan each pay a share of eligible costs that add up to 100 percent.
For example, if your coinsurance is 30 percent, you pay 30 percent of the cost of your covered medical bills. Your health plan pays the remaining 70 percent. If you meet your annual deductible in May, and need an EKG in July, it is covered by coinsurance.