Co-payment “co-pay”
The part of your medical/vision bill you must pay each time you visit the physician. This is a pre-set fee determined by your health insurance policy.
Co-insurance
The part of your bill, often in addition to a co-pay, that you must pay. Co-insurance is usually a percentage of the total medical bill. For example, 20%.
Deductible
The fixed dollar amount you must pay for medical or vision treatment before your health insurance company starts to pay. In most cases a deductible must be satisfied each calendar year.
Primary Health Insurance Company
The health insurance company that is responsible to pay your benefits first when you have more than one health insurance plan.
Secondary Health Insurance Company
The secondary health insurance company is not the first payer of your claims. The remaining claim balance will be sent to a secondary health insurance company, if provided, after payment is received by the primary health insurance company.
In-network
The physician has a contract with the health insurance company to provide you with medical care. The physician will submit your medical or vision bill directly to the health insurance company for payment. However, you may be responsible for a co-
payment, deductible and/or co-insurance according to your insurance benefits.
Out-of-network
The physician is not contracted with your the health or vision insurance company. You are responsible for the payment of your medical or vision care.