It’s officially Open Season for Federal Employees and we are here to help! As we continue our Understanding Open Season in Government series, let’s talk money:
How Will You Be Paying For This?
Out of Pocket: These are medical costs that you must pay out of your own pocket including deductibles, copays, and coinsurance.
Deductible: The amount of eligible expenses you pay each year for covered services before your health care plan begins to pay.
Co-Pay: Or copayment is the dollar amount you pay for specific health care expenses such as a $25 copay for an office visit to your primary care physician. In some plans, you pay a copay after you have met your deductible.
Co-Insurance: This is the percentage of health care expenses you pay after your deductible. Your health plan pays the rest up to any benefit or lifetime maximum.
Catastrophic costs (Out-of-pocket maximums) – this is a limit of how much you would pay out of pocket in a calendar year. These amounts may include deductibles, copayments and coinsurance amounts, as defined in your Plan brochure. Some out of pocket costs may not be eligible towards your maximum. Once this limit is met, benefits will normally be at 100% for covered health services for the balance of that calendar year.
So now that you know these important terms, you’ll be ready to fully understand what your plan or future plan include!
Information provided by Aetna.