Benefits Glossary
Benefits Glossary
Premiums: The amount you pay each pay period for your health insurance coverage.
Deductibles: Except for free preventive care, this is the amount of money that you must pay for care in a calendar year before your plan starts to pay. Your deductible determines how much you’ll pay for your doctor visits and other services. After you meet your deductible, you’ll generally only have to pay a copay or coinsurance for covered services.
Out-of-Pocket Limit: The most you’ll pay in a calendar year for covered services (not including premiums). After you reach this limit, the plan pays 100% of the costs.
Copays: A fixed amount you pay for certain services, like a doctor’s visit or prescription.
Coinsurance: Instead of a copay, you pay a percentage of the service cost. For example, with 80/20 coinsurance, the plan pays 80% and you pay 20%, until you hit your out-of-pocket maximum.
Network of Providers: Healthcare professionals and facilities that accept your insurance and offer lower, negotiated rates.
Coordination of Benefits: When you have coverage through more than one plan, this is how your insurers work together to determine which plan pays first. Memorial's plans are primary for employees; other plans may be primary for your dependents.