Health Insurance 3

Question 1

1. What applies to out-of-pocket maximums?

Answer 1

Deductible
Coinsurance
Any prescription Drug Cost Share amounts

Question 2

2. What does not apply to Out-of-Pocket maximums?

Answer 2

a. Non covered charges

b. Charges in excess of the allowed amount

Question 3

3. What is Cost Share?

Answer 3

It appears to be the amounts I will pay when I visit a doctor

Question 4

4. Will the Cost Share amounts vary?

Answer 4

Yes, based on the provider you choose, the type of services you receive, and the setting in which the services are rendered.

Question 5

5. Payment for covered services is based on our ALLOWED AMOUNT and MAY BE LESS THAN THE AMOUNT THE PROVIDER BILLS FOR SUCH SERVICES. Who is responsible for the difference?

Answer 5

I am. I am also responsible for any charges in excess of the allowed amount for out of network providers.