Definitions Continued
Copayment or Copay A set dollar amount you pay for certain health care services such as an office visit. Copays are usually paid at the time of the office visit. (e.g., A set dollar amount that PPO and HMO plan members pay for an office visit).
Coinsurance A set percentage of the total cost for a covered health care service that you pay after you have paid your deductible. For example, after your deductible is paid, plan members pay 10% of covered services and the plan pays the remaining 90%.
In-Network Providers In-network providers have contracted with Cigna Local Plus or Kaiser HMO and have agreed to provide a discount to Cigna or Kaiser plan members. You will pay less out of your pocket when you choose a Cigna Local Plus network provider if you’re on the Cigna health plan, or a Kaiser HMO network provider if you’re on the Kaiser health plan. Out-of-Network Providers Out of-network providers, facilities, and pharmacies can charge you the full price for services, which is typically much higher than the in-network discounted rate. You will pay more out of your pocket when you choose an out-of-network provider. Preventive Care Health care services that help keep you healthy by preventing diseases and other health conditions. The Cigna Local Plus and Kaiser HMO medical plans pay 100% of the cost of preventive care when it is provided by a Cigna Local Plus or Kaiser HMO provider. Some preventive care services that may be covered include: exams, screenings, and vaccinations. Please be aware that you may be billed for non- preventive care services that you receive at a preventive care exam. Learn more about preventive care at www.cigna.com or www.kp.org.
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