The only real must with this plan, is that you have to select a physician usually within a 30 mile radius of where you live, then upon each visit, you pay a Co-payment of a set amount to the physician. The Co-pay amount is determined by the health care plan you choose. If you need specialized care, then your primary physician coordinates the referral with the specialist.
 

Glossary of terms:

Co-payment:  is the amount due by you, the member, to the provider of the care.

Maximum Co-payment Limit: is the total annual amount of out of pocket expense that you are responsible for, before the Health Insurance Company begins coverage at 100%.

Covered Expense:  is the expense you incur for medically necessary services, and supplies listed in the benefits sections of the service agreement with the Health Insurance Company.

Deductible:  is the amount you must pay for Covered Expenses, before certain benefits are available to you.

Limited Fee Schedule: is the Health Insurance Companies listing of maximum amounts allowed for certain specific services provided by non-participating providers.