Health Insurance Glossary

Prescription Drug Options - RMHP Family plans offers several drug plans to pair with your RMHP Family health plan. The Prescription Drug Plan Description Form provides detailed benefit information about each plan.

Deductible - The annual dollar amount that you must pay before certain medical services will be covered.

Out of Pocket Max - The maximum each person or family will pay, per calendar year. Please note office visit copays, prescription drug rider copays and certain other benefit copays will continue to apply even after your out of pocket maximum is reached. For HSA plans, all deductible and coinsurance amounts apply to the out of pocket maximum.

Co-Insurance - The percentage of a covered health care service you must pay for after you have paid the full amount of the plan's deductible. There is no co-insurance on HSA plans.

Office Visit Copay - The amount you will pay each time you see a doctor. Copays are a flat dollar amount, like $35 per visit. There are no copays on HSA plans.

Lifetime Maximum – The maximum dollar amount RMHP would pay for one individual.

Participating Provider – Physicians, Hospitals, Clinics and licensed clinicians who contract with RMHP to provide care to our Members. Please refer to the Provider Directory for your specific plan

HSA - A tax-exempt bank account established specifically for the purpose of paying qualified medical expenses.

Value-Added Services – Services provided at no additional charge. Value-added services vary by plan.

Formulary – A comprehensive listing of prescriptions drugs (including injectable medication) covered by RMHP health plans.