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Glossary
Confused about copays? Not sure what an out-of-pocket maximum is? You’re not alone. Health care can be tough to navigate — so we’re here to help. Get to know common health care terms with our HMO plan glossary.
Coinsurance
A percentage of cost that you pay for services. For example, if you get a $100 procedure with a 20% coinsurance, you’ll pay $20 for that procedure.
Copay
A set amount you pay for covered services. For example, when you check in at your doctor’s office, the receptionist might say you owe a $10 copay for that visit.
Explanation of Benefits
A summary of the care you received and what your health plan covers. You’ll receive it after a visit, but it’s not a bill. You can use it to see how close you are to reaching your out-of-pocket maximum.
Out-of-pocket maximum
The most you’ll pay for covered services each year.*
Preventive care
A defined set of services designed to help catch health problems before they get serious — like mammograms, blood pressure screenings, and cholesterol tests. Getting preventive care when you’re healthy can help you stay that way. Visit kp.org/prevention to learn more.
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*A small number of services may not apply to your out-of-pocket maximum. For these services, you must keep paying copays or coinsurance after reaching your out-of-pocket maximum. See your Evidence of Coverage for details.