A co-pay is a designated dollar amount paid by the insured to receive specified services. This is payable at the time of service. Many insurance companies offer plans that have co-pays for doctor visits, prescription drugs and emergency room visits ($10, for example). Co-payments are separate from the deductible amount and normally do not apply toward the annual deductible. Additionally, the deductible does not usually need to be satisfied before a co-payment applies.

Just like fee-for-service plans, you should consult the patient's benefits booklet and/or contact the administrator's toll-free number printed on their DHA identification card.

This works the same way as the individual and family deductibles work. The individual in-network out-of-pocket maximum is the amount of expenses that one individual must accumulate before their in-network out-of-pocket maximums is met and the plan begins paying 100% of covered charges.

All plans are on a fiscal year and the period for satisfying deductibles and out-of pocket maximums are based on a July through June 30 fiscal year.

Deductibles are the first part of a claim that the Insured is responsible for. The deductible depends on the benefit the Insured is claiming for (ie. The Sect A Deductible is different then the Sect B deductible). The deductible is deducted per claim, per condition & per person and this is only deducted once at the beginning of each individual claim.

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The employer sets the maximum for the unreimbursed medical account. The maximum annual election for the dependent care is $5,000 per married couple filing jointly and $2,500 for singles.

Medicaid pays the deductibles, coinsurance and premiums for Medicare Part A and B for low income persons. These individuals are called "Qualified Medicare Beneficiaries" or QMB's.

Copayment - the dollar amount you pay for each in-network physician home or office visit. Physician copayments are for in-network care only. Network physicians agree to accept your copayment and UNICARE's reimbursement as payment-in-full for covered services if your plan pays 100% of the covered charge. If your Certificate of Coverage or plan booklet states that your plan pays less than 100% for physician office visits, you may have additional out-of-pocket costs.

The published rates for all plans include a zero deductible. The following deductible options and savings are available for the Single-Trip Emergency Medical Plan and the Multi-Trip Emergency Medical Plan: Please note: Deductible amounts apply to emergency medical coverage only. Deductible options are not available on the Single-Trip All-Inclusive plans or the Multi-Trip All-Inclusive plans.

No. Calculating deductibles requires access to the "Common Working File," which we cannot obtain because we are neither a provider nor an FI.

Deductibles apply for some services, such as hospital care, including inpatient facility charges, outpatient facility, home health care, ambulatory surgery centers and lab/x-rays performed outside of a doctor’s office visit. They also may apply for out-of-network office visits.

No. Payment of your monthly premium is all that is required. We settle all claims on your behalf directly with the service provider.

Yes, there is a $200 per plan year deductible for medical services provided outside of UHS. The deductible does not apply to services with fees at UHS or to pharmacy claims.

If your WizeCare plan includes the Accident Medical Benefit, then you have a $100 deductible FOR THAT BENEFIT ONLY. Otherwise, there are no deductibles, and you may begin saving with WizeCare as soon as your membership is active.

Please refer to the GMAC Real Estate Home Protection brochure for state specific plans and coverages. The GMAC Real Estate Home Protection Plan may include a claims maximum per covered claim as well as an aggregate claims maximum per Agreement term.

No! With PSBill, there are no barriers to your success. No monthly minimums or maximums will be imposed on your merchant accounts ever.

Dental deductibles may apply to Dental Care coverage for a variety of reasons, many of which are described in this Frequently Asked Questions section. Dental deductibles if applicable are as follows: $500 per covered person for basic and major services combined. Deductibles remain in place until the deductible is satisfied or 12 months have elapsed from the effective date of coverage, whichever comes first.