Annual Deductible
An annual deductible is the dollar amount an individual or family must first pay before your medical option starts to pay. For example, if your deductible is $1,000, your option won't pay anything until you've met your $1,000 deductible. Only covered healthcare expenses count towards the deductible.
Coinsurance
A coinsurance payment is the specific percentage of an eligible expense that you pay once the deductible has been satisfied.
Copayment
A copayment is a fixed dollar amount you pay for a covered health service, usually at the time you receive it. The amount may vary by the type of covered health care service.
Copay Option
Copay options require a paycheck deduction to enroll. When you receive care, you will pay a copayment when receiving care. Intel offers copay options in New Mexico and Oregon.
Eligible Expense
An eligible expense is a covered medical service paid at the contracted amount for in-network providers and paid up to the maximum allowable amount (MAA) for out-of-network providers.
HDHP
HDHP stands for High-Deductible Health Plan. There is no paycheck deduction to enroll in a HDHP option. When you receive care, you will pay 100% of the cost of care up to the annual deductible, and then a coinsurance until you reach your out-of-pocket maximum. Intel offers HDHP options in all states. With this option, you can choose to contribute to a Health Savings Account (HSA) to help pay for your medical expenses, which you can learn more about by clicking here.
HMO
HMO stands for Health Maintenance Organization. There is a paycheck deduction to enroll in this option type. When you receive care, you will pay copayments for in-network services. An HMO does not include out-of-network coverage, except for emergency care. Intel offers HMO options in Arizona, California and New Mexico. This option allows you to participate in a Health Flexible Spending Account (HFSA), which you can learn more about by clicking here.
In-Network
Each medical option has a network of contracted providers that provide discounts on covered medical services to members. You receive the highest level of coverage on covered medical services at the lowest cost by receiving care from any of the providers or facilities in the network.
Out-of-Network
Out-of-Network care is received from healthcare providers who do not participate in your medical option’s network. You will still receive out-of-network benefits if you choose to seek services outside of your medical coverage network, but services will cost you more because providers are not contracted to provide discounted services to members, and the services are covered at a lower out-of-network benefit level. Out-of-network providers may choose to balance bill you for any cost over the Maximum Allowable Amount that is not covered by your medical option.
Maximum Allowable Amount (MAA)
The maximum allowable amount is the amount your medical option will pay for a covered health care service and supplies. An out-of-network provider can charge the full amount for the service, but the amount covered is only the MAA amount. The MAA is often less than the amount charged to you by the out-of-network provider. You are responsible for any amounts charged by an out-of-network provider above MAA, even if you’ve already met your deductible and out-of-pocket maximum.
Out-of-Pocket Maximum
The out-of-pocket maximum is the most you will pay for covered services in a year. Once you reach out out-of-pocket maximum, your medical option will cover 100% of the cost. Out-of-pocket maximum doesn't include: your monthly paycheck deduction, anything you spend for services your medical option doesn't cover, or costs above the MAA for a service that an out-of-network provider may charge.
PCP
PCP stands for Primary Care Plus. There is a paycheck deduction to enroll in this option type. When you receive care, you will pay a copayment when receiving care from your primary care provider and a deductible then coinsurance for all other care. Intel offers PCP options in Arizona and Oregon. This option allows you to participate in a Health Flexible Spending Account (HFSA), which you can learn more about by clicking here.
Paycheck Deduction
A paycheck deduction is the amount of money deducted from your paycheck in order to be enrolled into the medical option. At Intel, you only have a paycheck deduction if you select an HMO, PCP or Copay option. You have no paycheck deduction if you select an HDHP.
Preventive Care
Preventive care are routine visits, vaccinations and certain screening tests that all Intel health options cover at 100%. Note: you may incur costs for diagnostic tests and/or procedures that your provider orders during your routine exam.
