When your covered healthcare expenses exceed the deductible, you and the plan begin sharing the cost by paying a percentage called coinsurance. Your deductible and coinsurance cover the cost you see—in other words, the part of your healthcare costs that is passed on to you. While Asurion continues to cover the majority of employee healthcare costs, each covered individual has a responsibility to use our benefits in the smartest way possible.

Your percentage of in-network coinsurance depends on the option you choose:

The out-of-pocket maximum is the total amount you could pay within a plan year for medical care and prescriptions. It does not include premiums taken out of your paycheck for health coverage. If you reach this maximum during the plan year, the plan pays 100% of covered services for the rest of the plan year.

Copays (short for “copayments”), are a fixed amount for a covered service collected when you see your provider, unless you have the Silver option. Copayments do not count toward the deductible or out-of-pocket maximum.

Your copayments depend on the option you choose:

Watch this video about the Health Savings Account, available with the Silver option, as you’re considering how to manage your out-of-pocket costs.

Healthcare flexible spending account (FSA)

If you have the Bronze Plus, Gold or Platinum option, you can pay with a healthcare flexible spending account. You can also pay with your personal debit or credit card. It’s important to note that in- and out-of-network deductibles and out-of-pocket maximum amounts accumulate separately.

No matter how you choose to manage your cost, keep in mind that during your benefits enrollment process is the best time for you to shop for just the right coverage. If you’re in the Platinum or Gold option, you can save a lot in premiums by considering the Silver or Bronze Plus options. You’ll want to add up how much you spent out-of-pocket last year to compare your options—in addition, make sure your providers are in-network if you switch. You can always use the Help Me Choose tool on Asurion Benefits Central or call to speak with a representative to make the best decision. See the link at the bottom of the page.

In-network providers have agreed to bill at rates approved by the plan. Always try to find an in-network provider to maximize your healthcare dollars.

Using in-network providers is a smart strategy for keeping your healthcare costs as low as possible. If you do choose to use out-of-network providers, be aware that in-network and out-of-network costs accumulate separately, and you will probably pay more out of pocket to meet both the in- and out-of-network deductibles.

Out-of-network providers are not held to the same pricing guidelines as in-network providers. They can charge whatever they want, even if a fee for a common service is well above average for the area. The reimbursement for out-of-network providers is a lower percentage AND the insurance carrier will only pay what they consider to be reasonable and customary. As a result, you end up paying even more out of pocket because out-of-network doctors will bill you for the cost difference that insurance doesn’t cover.