Deductible & Coinsurance

The deductible is...

• The amount the member has to meet before cost-sharing

• The amount BCBSNC has to pay before cost-sharing

• A cost-share between the member and BCBSNC

• The amount of coverage they will get from BCBSNC

Coinsurance is....

• The amount the member needs to meet before cost-sharing

• The amount BCBSNC has to meet before cost-sharing

• The cost-share between the member and BCBSNC

• The cost-share between two insurance companies

What needs to be meet first for coinsurance to begin?

• Copays

• Out-of-Pocket Maximums

• Deductible

Coinsurance is represented by...

• A set amount

• A percentage

• A maximum amount

Deductibles need to be met before Coinsurance begins. True or False?

• True

• False

The maximum amount a provider will be reimbursed as negotiated by the provider contract is called....

• Balance Bill

• Allowed Amount

• Deductible

• Coinsurance

The difference between the allowed amount and the billed amount is called....

• Deductible

• Allowed Amount

• Liability

• Balance Bill

If a member uses an INN provider, they are responsible for....

• The Allowed Amount

• The Balance Bill

• The Allowed Amount and The Balance Bill

• None of the answers provided

If a member uses an OON provider, they are responsible for...

• The Allowed Amount

• The Balance Bill

• The Allowed Amount and Balance Bill

• None the answer provided