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What is the difference between a co-pay and co-insurance? Learn the definitions of benefits terms to help you make the best decisions for you and your family.

  • Co-pay: The fee that you pay toward the cost of certain covered medical expenses. Copayments do not apply to the out-of-pocket annual maximums.
  • Co-Insurance: For our medical plans, this is the 10 percent you pay for certain services when using a Tier 1 provider after the deductible has been met. You pay more in co-Insurance when using Tier 2 or Out-of-Network providers.
  • Dependent Care Flexible Spending Account. You can save up to $5,000 (married/joint return or head of household) through a pre-tax payroll deduction to use for day care, non-residential summer camps and elder care for eligible dependents. You must designate the amount during Open Enrollment.
  • Health Care Flexible Spending Account. You can save and pay for covered health care services and qualified medical expenses by contributing to this account. You must designate the amount during Open Enrollment and any unused funds at year-end are forfeited.
  • Health Reimbursement Account. It’s an account set up by Palmetto Health for HRA medical plan participants to help you pay for covered health care services and qualified medical expenses. You cannot contribute to this account.
  • Health Savings Account. An HSA is a personal bank account to help you save and pay for covered health care services and qualified medical expenses. You must be a participant in the high-deductible HSA plan to qualify for this tax-advantaged account. You and Palmetto Health put money into this account. (Your contributions are pre-tax.) You can use it to pay for covered health care costs incurred now or in the future. The account earns interest.
  • Out-of-Pocket Annual Maximum: The maximum amount you pay in deductible and coinsurance in a plan year. Once met, the plan will cover all remaining eligible costs for the rest of the plan year, except co-pays.
  • Primary Tier Network. You maximize your benefits by using a Primary Tier Network provider or facility. The primary tier consists mostly of Palmetto Health facilities and Quality Collaborative physicians.
  • Secondary Tier Network. The secondary network tier consists of all providers in BCBS’ national network that haven’t already been included in the primary tier.
  • Out-of-Network. Care you receive from a non-network service provider. Out-of-network health care and plan payments are subject to higher deductibles and coinsurance.

Related Links

Enrollment Information

New Benefits for 2018

Have a Question?
Contact the Total Rewards Benefits Center at 800-963-3456 or 803-296-8893, or email TotalRewards
@PalmettoHealth.org