Co-insurance is a percentage of the healthcare bill that you pay. Some plans have a co-insurance requirements for which you are financially responsible. For example, under plans with 80/20 arrangements, you are responsible for paying 20% of the allowable charge, and your insurance company pays the other 80%. Your out-of-pocket cost, in this example the 20%, is based on the total amount that your insurance has allowed for the visit – not on the clinic charges.

A deductible is the annual expense you are required pay before your health insurance pays anything. Deductibles do not apply to all services, so it is important to understand your plan and its coverage. For example, your plan may require that you pay the first $1,000 of your healthcare bills before your health insurance pays anything. Your out-of-pocket cost is based on the total amount that your insurance has allowed for the visit – not on the clinic charges. In instances where the services you are receiving are subject to your deductible, you will be financially responsible for the charges until you have met your deductible. Once the deductible is met, the insurance company will then begin to pick up some of the financial responsibility for the services.

A co-payment is the amount you pay when you go to a healthcare provider. Providers collect co-payments at the visit. Co-payment amounts are listed on your health insurance card. In some instances, amounts above the co-pay may be required, depending on your plan, the services and your deductible and/or co-insurance requirements.

An EOB is the notice you receive from your insurance company after receiving services from healthcare provider. The EOB tells you what the service was, what was billed, the payment amount approved by your insurance, the amount that was paid to the provider and what you are required to pay under this contractual arrangement