: The terms 'covered benefit' and 'covered' are utilized regularly in the insurance coverage industry, however can be confusing. A 'covered advantage' normally refers to a health service that is consisted of (i. e., 'covered') under the premium for a given health insurance coverage policy that is paid by, or on behalf of, the enrolled client. 'Covered' means that some portion of the allowed cost of a health service will be considered for payment by the insurance provider. It does not indicate that the service will be paid at 100%. For example, in a plan under which 'immediate care' is 'covered', a copay may use.If the copay is $100, the client has to pay this amount (normally at the time of service) and then the insurance plan 'covers' the rest of the enabled expense for the immediate care service. In some instances, an insurance provider might not pay anything towards a 'covered benefit'. For instance, if a client has not yet met an annual deductible of $1,000, and the cost of the covered health service provided is $400, the patient will need to pay the $400 (often at the time of service). What makes this service 'covered' is that the expense counts toward the annual deductible, so just $600 would stay to be paid by the patient for future services prior to the insurance business starts to pay its share.