Navigating health insurance can feel overwhelming, especially when you are trying to focus on your mental health and well-being. At TrueCandor Behavioral Health, we often hear questions about deductibles, copays, coinsurance, and something called coordination of benefits. These terms can be confusing, but understanding them can help you avoid unexpected bills and feel more confident about your care. 

Below is a clear and simple breakdown of each concept and why it matters.

What Is Deductible?

A deductible is the amount you pay out of pocket for healthcare services before your insurance plan begins to cover costs.

• Example: if your deductible is $1,000, you pay the first $1,000 of covered services yourself.

Some services, such as preventive care or certain mental health visits, may be covered before you meet your deductible. This depends on your specific plan. 

What Is a Copay?

A copay is a fixed dollar amount you pay at the time of service.

• Example: You may have a $25 copay for therapy sessions.

Copays are usually predictable, which makes it easier to budget for routine appointments.

What Is Coinsurance?

Coinsurance is a percentage of the cost of a service that you pay after you meet your deductible.

• Example: Your plan may require you to pay 20 percent of the cost of your session, while insurance covers the remaining 80 percent.

Coinsurance often applies to higher-cost services, or once your deductible has been met.

What Is a Coordination of Benefits (COB)?

If you have more than one insurance plan, for example, through your employer and a spouse, Coordination of Benefits (COB) determines:

• Which plan pays first, also called primary insurance
• Which plan pays next, also called secondary insurance
• How the remaining costs are shared

Insurance companies require this information to ensure claims are processed correctly. If COB information is missing or outdated, claims can be delayed or denied.

Why Understanding These Terms Matters?

Having clarity about your insurance coverage can help you:

• Plan for your out-of-pocket costs
• Reduce billing surprises
• Know what to expect at each visit
• Make informed decisions about your behavioral health care

At TrueCandor Behavioral Health, our goal is to simplify the insurance process so you can stay focused on your healing and well-being, not on paperwork.

If you ever have questions about your benefits or how claims are handled, our team is here to help.