What Is a Deductible?

A deductible is the amount you may be responsible for paying toward covered healthcare services before your insurance plan begins paying according to the plan’s benefits.

For example, if your plan has a deductible that has not yet been met, you may be responsible for a larger portion of your visit cost.

Once your deductible is met, your plan may apply different benefits, such as a copay or coinsurance.

Every insurance plan is different, so we recommend checking your individual benefits.

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What Is a Copay?

A copay is a fixed amount you may be responsible for paying for a covered healthcare service.

For example, your insurance plan may specify a $30 copay for a chiropractic visit.

Your actual copay depends on your specific insurance plan.

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What Is Coinsurance?

Coinsurance is generally the percentage of a covered service that you are responsible for paying after your deductible requirements have been met.

For example, if your plan has 20% coinsurance, your insurance company may pay its portion while you are responsible for the remaining percentage of the allowed amount.

Your actual responsibility depends on your plan and how your insurance company processes the claim.

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What Is an Allowed Amount?

An insurance company’s allowed amount is the maximum amount the insurance plan recognizes for a covered service under the applicable plan terms.

Your responsibility is based on your specific insurance benefits and how the claim is processed.

This is one reason the amount you see on a statement may not be the same as the original amount billed to insurance.

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Frequently Asked Questions

Do you accept my insurance?

We currently accept eligible plans through:

• Anthem Blue Cross Blue Shield
• UMR
• UnitedHealthcare
• Aetna
• Cigna
• Medicare
• Medicare Railroad
• Encore for City Employees

Because individual plans can vary, we’ll verify your specific benefits whenever possible.

Are you in network with my insurance?

We are in network with most major insurance companies listed above, but network participation can vary by specific plan.

The best way to confirm your benefits is to provide our office with your current insurance information so we can verify your coverage.