Covered vs. Not Covered

“Covered” means that the service is payable AFTER your deductible is met or it is payable AFTER a copay is paid.  A few services, such as State mandated preventive care services like immunizations, mammograms and prostate screenings, are covered without being subject to a deductible or a copay.  But many people mistake deductible expenses as expenses that are “not covered”.  For example, if your PPO plan’s annual deductible has not been met yet, a trip to the lab for bloodwork might result in a deductible expense, an expense that reduces your calendar year deductible, and you will be required to pay the network discounted fee for the blood test.  This service is considered a “covered” expense, even though you have to pay for it.  If the service is “not covered”, it will not reduce your calendar year deductible.

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