Health insurance vocabulary can feel like a second language. Here's a plain-English guide to the terms that actually affect what you pay.
Your deductible is the amount you pay out of pocket each year before your insurance starts covering costs. After you meet it, you typically pay a smaller share (your coinsurance) until you hit your out-of-pocket maximum.
In-network providers have a contract with your insurance company and accept negotiated rates. Out-of-network providers don't — and you'll usually pay significantly more, sometimes the full bill. Always confirm a provider is in-network before booking.
A copay is a fixed amount you pay for a specific service (e.g. $30 for a primary care visit). It usually applies before or alongside your deductible, depending on your plan.
Prior authorization means your insurer must approve certain procedures or medications before they'll cover them. Imaging, surgeries, and specialty drugs commonly require it. Skipping this step can mean paying the full cost yourself.
When in doubt, ask your coordinator to verify coverage and obtain prior authorization before your appointment. We do this on every booking — so you walk in knowing exactly what you'll owe.