The cost of your insurance policy

Pre-existing Condition

A health condition you had and knew about before you enrolled in your medical plan.

Out-of-pocket Maximum

The most you’ll pay for covered services in a calendar year. Many survivors hit their out-of-pocket maximums each year.

Doctors and facilities that do not have a contract with your insurance company. You can submit the claims to your insurance company, but you will likely owe more, since insurance won’t cover as much of the cost.

The maximum amount your insurance plan will pay during your lifetime.

Doctors and facilities that have a contract with your insurance company; typically your costs are lower since insurance will cover more of their fees.

Explanation of Benefits (EOB)

Sent by your insurance company telling you what was billed to your insurance; what insurance paid; and the estimate of what you’ll owe. This is NOT a bill.

What you must pay before your insurance benefits cover costs.

What you pay right away when you check in at the doctor’s office or pick up a prescription. This is determined by your insurance plan.

Your health insurance covers a service after you have paid your deductible, but you’re still responsible for a percentage. For example, you pay 25% of a bill in coinsurance, and your insurance pays 75% of the bill.