What you pay to stay covered
Your monthly premium keeps this policy active and is separate from the costs below. The amounts on this Explanation of Benefits are what was charged for a specific visit and how your plan shared that cost with you.
Your share of this visit
Each year you pay a deductible before the plan begins paying its portion. For routine services you may instead pay a flat copay. Once the deductible is met, you pay coinsurance — a percentage of each bill — while the plan covers the rest, until your spending reaches the out-of-pocket maximum and the plan then covers all remaining covered care for the year.
Network
This claim was processed as in-network, meaning the provider has an agreement with Meridian to charge agreed rates, so your share is lower. Care received out-of-network is generally charged at higher rates or may not be covered.
Optional coverage and recovery
If you have added a rider to your plan, the extra benefits it provides are applied separately. Where another party was responsible for an injury, the plan may exercise subrogation — recovering from that party what it paid on your behalf.