Common use of Copayment and Coinsurance Requirements Clause in Contracts

Copayment and Coinsurance Requirements. Covered Services rendered by certain Health Care Providers will be subject to a Copayment or Coinsurance requirement. This is the fixed dollar amount (Copayment) or percentage (Coinsurance) of the Allowed Amount or Maximum Allowable Payment you have to pay when you receive these services. Please refer to your Schedule of Benefits for particular Covered Services that are subject to a Copayment or Coinsurance. All applicable Calendar Year Deductible, Copayment or Coinsurance amounts must be satisfied before we will pay any portion of the cost of Covered Services during the same calendar year.