With my insurance there is my deductible (the amount I first have to pay, before my insurance kicks in - on your explanation of benefits you’ll see the provider charge - the negotiated discount and whatever is left you pay out of pocket, and it goes towards satisfying your deductible). I think my individual is $300 my family is $600. Those are the bills you get if they run tests or there’s charges beyond the office visit. Your co-pay and out of pocket costs go towards satisfying that amount. My insurance has co-pays for office visits (not all ins have this, if you do it’s usually written on the front of your card (ex $25 PCP office visit, $25 specialist, it may even list an ER or urgent care). I pay that every time I check out (or some places process that at check-in). Once my deductible is satisfied, my insurance will process the bill from all of the submitted claims (applying their negotiated discount with that provider - again, you’ll see that on your explanation of benefits from your insurance as they process each claim) - and my insurance plan will pay 80% of the allowed expenses and I pay the remaining 20%. You should see an out of pocket maximum that is set in you benefits booklet or listed on your explanation of benefits that comes in a mail from the insurance company when a claim is processed. (we have a new plan that started July 1st, I don’t remember my new limits) … for example an out of pocket maximum could look like: a set amount for an individual (ex. $4,000) or a higher set amount for everyone covered under a family plan (ex. $18,000). So that means if you tally up all the out of pocket medical bills for a member during a plan year, the plan will pay 100% coverage when an individual or family meets that designated amount that they have spent out of pocket. (I’m not sure I’ve ever met that amount, but I think we came close one year when two family members had a surgery… or possibly when I had my kids 20 odd years ago). The law requires that a facility give a good faith estimate to you upon request, so if you are concerned you could reach out to your program insurance or billing coordinator to go over the financials and expected insurance coverage. I’ve heard of some places requiring payment upfront before surgery and others (like mine) billing post surgery … so your office should be able to tell you their policy. Since mine is within a hospital network, they will also do the zero interest medical payment plans if requested for balances over a certain amount. They should also be able to tell you that policy if you get a pricing estimate. My program - each office bills individually for tests and consults, then the hospital will bill me for the surgery, but all accumulate towards the deductible and out of pocket totals. I hope that helps.