Common Insurance Terms Premium: The amount you pay for insurance Medical Copayment (copay): The fixed amount you pay to receive services Deductible: The amount of money you are responsible for before insurance kicks in and starts paying their portion Coinsurance: The percentage of cost that is split between you and the insurance carrier once your deductible is met Out-of-Pocket Maximum: The most you will pay per plan year for health care expenses, including deductibles, flat dollar copays and coinsurance Amounts shown below are your responsibility. This table only shows in-network benefits BCBS BCBS BlueCross BlueShield of Oklahoma $1,500 PPO $500 PPO Plan Network Blue Advantage Blue Advantage After deductible, BCBS pays 80%, After deductible, BCBS pays 80%, Coinsurance employee pays 20% employee pays 20% Primary: $25 Primary: $25 Office Visit Copay Specialist: $25 Specialist: $25 Preventive Care Covered in Full Covered in Full Urgent Care Copay $25 Copay $25 Copay $200 Copay, then Deductible & $200 Copay, then Deductible & Emergency Room Coinsurance Coinsurance Outpatient Hospital Services Deductible & Coinsurance Deductible & Coinsurance Inpatient Hospital Services Deductible & Coinsurance Deductible & Coinsurance Individual: $1,500 Individual: $500 Plan Year Deductible Family: $6,000 Family: $2,000 Individual: $5,000 Individual: $5,000 Medical Out-Of-Pocket .Maximum Family: $10,000 Family: $10,000 Prescription Coverage* Copays OU Health / BCBS Generic $0 / $15 Preferred Brand Greater of: 20% or $40 / 30% or $60 Non-Preferred Brand Greater of: 20% or $60 / 35% or $90 Specialty Greater of: 30% or $100 / 40% or $200 8