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Health Care Reform:

Health Insurance & Affordable Care Act

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Allowed amount

The allowed amount is the most a health plan will pay for a health service. A health service could be a test, procedure, or something else. Your plan's in-network providers have signed a contract to provide services at a discount. They agree not to charge more than this allowed amount to members of the health plan.

Out-of-network providers may charge more than the allowed amount. If you see an out-of-network provider who charges more, you may have to pay the extra cost. You can avoid having to pay more by only using providers in your health plan's network.

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Health Insurance Terms

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