Co-insurance refers to the cost-sharing concept of international insurance whereby insured has to share his/her medical expenses with the insurance company. The portion of the share on the insured’s part is minimal and the major portion falls under the responsibility of the insurance. In most plans with unlimited maximum coverage, the standard co-insurance portion for insurance company is 80% of every medical bill and remaining 20% is to be paid by the student. Co-insurance forms the major portion of the Out-of-pocket maximum limit.

“More the co-insurance portion for insured less the premium for the particular insurance plan option”

Co-payment is a nominal amount paid by the insured for each consultation or treatments at particular medical providers such as physicians, urgent care, specialists, Emergency rooms among others. It is also applied to Prescription drugs in some plans. IT may range from $5 to $500 approx. depending upon the plan options.

It is the maximum amount paid by an insured(student) from his/her pocket for all the medical expenses during an insurance period. Once the student reaches the mentioned ‘out-of-pocket maximum’ limit according to one medical bill or all the bills combined, the insurance covers 100% of the allowed amount for covered services.

It is used in medical care both to refer to a type of patient, or to refer to a type of care.

Inpatient simply means someone who is a patient in a hospital. An inpatient is confined to the hospital for treatment.

Outpatient treatment refers to every other treatment except inpatient. As the patient is not confined to a hospital for a period longer than that of the consultation or treatment duration.

Medical providers such as Physicians, Hospitals and other healthcare providers who have been contracted to provide medical care at negotiated prices. Preferred Providers are also called
In-network providers, which refers to the providers which are in the network or system of the Insurance company or its claims administrator. For e.g. GBG insurance plans uses Aetna provider network to manage their network of medical providers in the US.

Preferred allowance is the amount a Preferred Provider will accept as payment in full for covered medical treatment. The difference between standard medical expenses and Preferred allowance is considered as discount in the EOB(claim explanation) document.

The fee or price the insurer determines to be Usual, customary and reasonable charges for healthcare services. The insured is responsible for the payment of any balance over and above the allowable charge. This does not apply while

Fees and prices generally reimbursed within the locality where performed for medically necessary services and supplies required for treatment of cases of comparable severity and nature.

Payment of medical expenses benefits is subject a lifetime aggregate maximum per individual insured person as long as plan remains in force. It includes all benefit maximums specified in this Schedule of benefits plan.