Insurance · Module 4 of 4
What you still pay
Copays, coinsurance and your yearly maximum, and why the cheapest monthly price isn’t always the cheapest year.
Key terms in What you still pay
- Deductible
A deductible is the amount a person pays for covered health care services before the insurance plan begins to pay its share. Once the deductible is met, the plan typically starts sharing costs through copayments or coinsurance. Deductibles usually reset each plan year, and some services, such as certain preventive care, may be covered before the deductible is reached.
- Coinsurance
Coinsurance is the percentage of the cost of a covered health care service that the patient pays after meeting the plan's deductible. The insurer pays the remaining percentage of the allowed amount. Plans with lower monthly premiums often have higher coinsurance, and the patient's share continues until the plan's out-of-pocket maximum is reached for the year.
- Out-of-pocket maximum
An out-of-pocket maximum is the most a person must pay for covered services in a plan year. After deductibles, copayments, and coinsurance reach that limit for in-network care, the plan pays the full cost of additional covered benefits. The limit does not include monthly premiums, services the plan does not cover, or charges above the plan's allowed amounts.
Source: HealthCare.gov, Out-of-pocket maximum/limit (glossary)
Every term on Lever is in the money glossary.
About this module
What you still pay is part of Insurance, one of 15 subjects in Lever. It’s a short run of 6 lessons, about 15 minutes in all, so you can finish it in one sitting.
Every lesson takes one idea at a time. You read it with the math worked out step by step, answer a question that puts it to use, then see why the right answer is right and why the others aren’t.
It’s for anyone who was never taught this, and you don’t need to know anything first. Every lesson is free. Lever works out what you already know, so you can start here or let your path bring you to it.
More in Insurance
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1
When something goes wrong
How insurance works: premiums, deductibles, filing a claim, and the gaps public coverage leaves.
9 lessons -
2
Covering yourself before you can afford to
Protecting yourself before you can afford a policy: the risks that matter most and what to build toward first.
5 lessons -
3
What a policy is for
Liability cover, life insurance for the people who rely on you, and the fine print about what a policy won’t pay for.
5 lessons
Try this module
It’s part of Insurance. Lever will bring it to you when you’re ready, or you can go straight there.