Maximum amount on which payment is based for covered health care services.  This may be called “eligible expense,” “payment allowance" or "negotiated rate."  If your provider charges mo [..]

A request for your health insurer or plan to review a decision or a grievance again.

When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill yo [..]

A financial payment made by your health plan for covered services or drugs.

The percentage of health care costs you are responsible for paying – usually after your plan’s deductible is met.

Conditions due to pregnancy, labor and delivery that require medical care to prevent serious harm to the health of the mother or the fetus. Morning sickness and a non-emergency caesarean section aren’ [..]

A fixed dollar amount you must pay with your own money for medical services, such as office visits, or prescription drugs.

The health care costs that are your responsibility to pay, including deductibles, copays, coinsurance, and other costs not covered by your health plan.

The costs your health plan pays for your medical services or prescription drugs.

The amount you must pay each year – with your own money – before your health plan begins paying benefits.