Key Terms to Know


Here are some key terms to know when reviewing your health plans:
  • Deductible: The amount you pay before the plan begins to pay.
  • Out-of-pocket maximum: The maximum amount you pay for covered services in a year.
  • Plan coinsurance: Percentage of the charge that your plan will pay, typically after you have met the deductible.
  • Copay: An amount you pay for a covered service each time you use that service. It does not apply toward the deductible.
  • Out-of-pocket costs: Expenses you pay yourself, such as deductibles, copays, and uncovered services.
  • Prescriptions: Medications are grouped into tiers, and the tier that your medication falls into determines your portion of the drug cost.
  • Preventive care: Services intended to help detect and prevent potential health problems early on. Under all our medical plans, you pay nothing for in-network annual physicals, recommended immunizations, routine cancer screenings, and more as long as you stay in-network. See all fully covered preventive care services.
  • Evidence of Insurability (EOI): An application process in which you provide information on the condition of your health or your dependent’s health in order to be considered for certain types of insurance coverage.