Coverage FAQs
What is a copayment (copay)?
A copay is the amount paid at the time of service for certain medical services and prescription drugs. Copays do not apply to deductibles or out-of-pocket maximums. For UT SELECT, when using in-network providers, the office visit and preventive care copays depend on whether the doctor is a family care physician (FCP) or a specialist.
What is the difference between a family care physician (FCP) and a specialist?
Family care means care provided by family practitioners, internists, OB/GYNs, and pediatricians. All other physicians are specialists.
What is a deductible?
A deductible is the amount of out-of-pocket expense that must be paid for health care services by the covered person before becoming payable by the health care plan. UT SELECT features a "Plan Year" deductible. The plan year begins September 1 and ends August 31 of the following year.
What does out-of-pocket maximum mean?
When a person reaches the plan's out-of-pocket maximum, UT SELECT then pays 100% of any eligible expenses for the rest of the plan year. The amounts include the deductible. Copays will continue to apply after the out-of-pocket maximum is met.
What is coinsurance?
Coinsurance is the percentage of medical expenses that you and the plan share. For example, when using in-network providers, UT SELECT pays 80% of the allowed amount and you pay 20% of the allowed amount after the deductible is met.
