Cost sharing is the part of your visit cost that your insurance plan asks you to pay. It’s set by your insurance company, not by Fay. Common cost-sharing terms include:
Copay: A fixed amount you pay per visit, such as $30.
Deductible: The amount you pay before your plan starts covering part or all of your visits.
Coinsurance: A percentage of the visit cost you pay after you meet your deductible, such as 20%.
Out-of-pocket maximum: The most you’ll pay for covered services during a plan year. Once you reach it, your plan typically covers eligible visits in full.
A denied claim is different from cost sharing. A denial means your insurance plan did not cover the service rather than applying a copay, deductible, or coinsurance.
Why your cost may change:
Your insurance processed a claim and applied cost sharing.
Your appointment length, since longer sessions can cost more.
The diagnoses on your claim, which can affect how a visit is covered.
Changes to your plan’s policies, or a new plan year resetting your deductible.
Your progress toward your deductible or out-of-pocket maximum.
Appointments before you were notified of future cost sharing are still protected by the Fay Guarantee. If you were charged more than your estimate for an appointment that occurred before you were notified, you can request a refund for the difference in your Billing tab.
To confirm your plan’s requirements and get the most accurate information about your specific coverage, we recommend contacting your insurance company using the number on the back of your insurance card. You can also learn more about how Fay estimates appointment costs and when payments are processed.