---
title: Understanding Health Care Costs
description: Understanding how your plan works will help you know how much you will pay out-of-pocket for covered services.
---

[The CRBG Blog ](https://blog.compassrosebenefits.com)

# [Understanding Health Care Costs](https://blog.compassrosebenefits.com/understanding-health-care-costs)

 Written by [Jacqueline Bailey](https://blog.compassrosebenefits.com/author/jacqueline-bailey) | Aug 31, 2023 7:52:40 PM

Health insurance lingo can be confusing. What is the difference between a copayment and coinsurance? What is a deductible? Understanding how each works will help you know how much you will pay out-of-pocket for covered services. 

## Defining Health Care Cost Terminology 

### Out-of-Pocket Limit 

The most you could pay during a coverage period (usually one year) for your share of the costs of covered services. After you meet this limit, the plan will usually pay 100% of the allowed amount. This limit helps you plan for health care costs. This limit never includes your premium, balance-billed charges or health care your plan doesn’t cover. Some plans don’t count all your copayments, deductibles, coinsurance payments, out-of-network payments, or other expenses toward this limit. 

### Deductible 

An amount you could owe during a coverage period (usually one year) for covered health care services before your plan begins to pay. An overall deductible applies to many covered items and services. A plan with an overall deductible may also have separate deductibles that apply to specific services or groups of services. A plan may also have only separate deductibles. 

### Coinsurance 

Your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You generally pay coinsurance plus any deductibles you owe.  

### Copayment 

Your copayment is the amount you pay for a covered service. Your copayment amount will not change throughout the year, and usually does not count towards your deductible. For example, you may pay $15 each time you see your primary care provider.  

## How These Costs Apply to Your Plan 

To put your costs into perspective, let’s explore these terms based on the High Option Compass Rose Health Plan rates for 2023.

**Example 1: Compass Rose Health Plan High Option Deductible (for self only) is $350** 

If your plan's deductible is $350, you'll pay **100% of eligible covered services and supplies until you reach $350**. Once you have met your deductible, your coinsurance will kick in. 

**Example 2: Compass Rose Health Plan High Option Coinsurance is 10%** 

If you have 10% coinsurance, **you pay 10% of the allowed amount of the bill**, and your health insurance will cover 90%, once you meet your deductible. 

**Example 3: Compass Rose Health Plan High Option Out-of-Pocket Max (for self only) is $5,000** 

**You reach your $5,000 out-of-pocket maximum after undergoing a medical procedure**. Now, your plan will pay the full cost of your covered services for the remainder of the year. 

[View full post](https://blog.compassrosebenefits.com/understanding-health-care-costs)

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