Fee-for-Service or major
medical group health
insurance provides benefits
up to a high limit for most
types of medical expenses
incurred, subject to a
deductible. Once the
deductible is met, this type
of group health insurance
plan will pay a percentage
of what is considered the
"Usual and Customary"
charge for covered
services. The insurance
company generally pays
80% of the Usual and
Customary costs and you're
responsible for paying the
other 20%, which is known
as co-insurance. If the
insurance company charges
more than the Usual and
Customary rates, you will
need to pay both the co
insurance and the
difference.
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