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Allowed Amount

What Does Allowed Amount Mean?

The maximum amount a plan will pay for covered health care services. It may also be referred to as an “eligible expense”, a “payment allowance”, or a “negotiated rate”.

If your provider charges more than the amount allowed under the plan, you may have to pay the difference.


“Glossary.” HealthCare.gov, www.healthcare.gov/glossary/.

CMS.gov. Glossary of Health Coverage and Medical Terms. CMS.gov, 2020. https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Uniform-Glossary-01-2020.pdf. PDF file.

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