Out of Pocket Costs
When using the Brown University Student Health Insurance Plan, you may encounter some out of pocket expenses:
- There is a $300 deductible per person, per policy year. However it is waived for
- Emergency Room visits
- Diagnostic X-Rays and Laboratory Tests when ordered by Health Services
- Outpatient mental health visits
- Physician office visits
- In-network preventative screening/lab
- Outpatient prescription drugs
- Other outpatient services when provided by University Health Services
- There is a $100 copay for inpatient hospitalization or outpatient surgery performed at a hospital or hospital affiliated surgical center. This is in addition to the $300 deductible.
- Doctor visits have a $15 copay.
- Emergency Room visits have a $100 copay.
- Urgent Care Center visits have a $25 copay.
- After a copay, prescriptions will be covered at 100% (in network). Copays are $15, $30 or $50.
- You will be charged co-insurance when using out-of-network providers.
Copay - A specified dollar amount an insured person must pay for specific services. Copay is per date of service, per visit or per prescription.
Deductible - A specified dollar amount an insured person must pay before the insurance company will pay a claim. Deductible is once per policy year.
Co-insurance- An insured person and the insurance company share the payment made against a claim, which may be in addition to a copay (For example: for out-of-network providers covered at 70%, you would pay 30% co-insurance.)
Preferred Allowance - The amount a preferred provider will accept as payment in full for covered services.
Usual and Customary Charges - The average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.
Preferred Providers - The physicians, hospitals and other health care providers who have contracted to provide specific medical care at negotiated prices.
Out-of-Network Providers - Providers have not agreed to any prearranged fee schedules.