KEY MEDICAL TERMS PCP A PrimaryCarePhysiciandesignatedwith yourhealthplanwhoprovidesthe first contact of care. The PCPwill also provide referrals for specialist services as needed DEDUCTIBLE Theamountyouneedtopayeachyearforeligiblehealthcare expensesbefore insurance paymentsbegin COPAY A fixed amount you pay each time you get a healthcare service [doesn’t apply to BB&N plan] COINSURANCE Thepercentage of costs of a covered healthcare service you pay (i.e. 20%) after you have paid your deductible. For example: You receive a service for $100 that requires you to pay coinsurance. Your deductible has been met. You will pay 20% of the $100 service, or $20. [doesn’t apply to BB&N plan] OUT-OF- POCKET Themaximumamountyoupayeachyearforeligiblehealthcare expensesin deductible, MAXIMUM copayments, and coinsurance [doesn’t apply to BB&N plan] ALLOWEDAMOUNT Maximumamountonwhichpaymentisbasedforcoveredhealthcareservices.Thismaybecalled “eligible expense,” “payment allowance,” or “negotiated rate.” If your provider charges more than the allowed amount, and is out of network, you may have to pay the difference. (Out of network) When a provider bills you for the difference between the provider’s charge and the BALANCEBILLING allowed amount.For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services.