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Insurance lingo and understanding your policy. Pssst, you might be covered at 100%!




Believe it or not, there are a lot of people who are unaware of what their insurance policy actually offers them. Majority don't even know what their deductible or out of pocket is, much less if they've met it for 2020. I think we've all been confused at some point about our insurance policy, but it doesn't have to be intimidating!


Our team at RPT are happy to help you understand the "lingo" and how to get the most out of your insurance policy! Meeting your deductible and/or out of pocket max can mean considerably cheaper Physical Therapy visits.


Do you have Medicare? You could be covered at 100% at no cost to you!


Insurance can sound like a foreign language, so we've put together a short list to help you better understand your policy.


Premium: This is the amount that an individual or employer pays for an insurance plan. This is usually paid for on a monthly basis, but can be paid for quarterly or annually as well.


Deductible: Your deductible is what you have to pay out of your pocket, before your insurance policy begins to pay for services. For example, if you have a $2,000 deductible, you are financially responsible for services until that $2,000 has been satisfied. Once you have met your deductible, your insurance begins to pay for services, but you will likely still be responsible for a co-pay or co-insurance.


Co-Pay vs Co-insurance or cost share: A copay is typically a set dollar amount. You can expect to pay this at any visit after you've met your deductible. A co-insurance (or cost-share) is usually a percentage of the services rendered. If services cost $100 and your copay is 25%, you would be responsible for paying roughly $25.


Out of Pocket Max: This is the the most you will pay for medical services rendered for the year. Once you have that amount, you are covered at 100%


As always, we are here to help and would be happy to answer any questions!


RPT Staff



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