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Understanding your health care coverage and the cost of your care
Members
Health Plan Basics | Members
Understanding Your Cost of Care
Cost of Care
Learn more about the cost of your insurance.
100%
80
/
20%
100%
Preventive Care
The Health Plan will pay
100% for many of these
services when you visit
participating providers.*
* UPMC Health Plan will cover many adult and child preventive services at 100%
if the services are received from a participating provider and billed as preventive.
Copayment
This is a flat fee you must
pay for covered health
care services. The amount
will depend on the service.
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Annual Deductible
You must pay 100%
Coinsurance
You must pay for a percentage of
your care and UPMC Health Plan
will pay for a percentage.
(80% and 20% are typical cost-sharing
amounts but they may not be accurate for
your plan. Check your plan documents,)
Annual Out-of-
Pocket Maximum
UPMC Health Plan will pay
100% once you meet your
out-of-pocket maximum.
My
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