: The terms 'covered benefit' and 'covered' are used regularly in the insurance coverage industry, but can be complicated. A 'covered benefit' generally describes a health service that is consisted of (i. e., 'covered') under the premium for an offered medical insurance policy that is paid by, or on behalf of, the registered client. 'Covered' indicates that some portion of the allowable expense of a health service will be considered for payment by the insurer. It does not mean that the service will be paid at 100%. For instance, in a plan under which 'urgent care' is 'covered', a copay may use.If the copay is $100, the client needs to pay this amount (normally at the time of service) and after that the insurance coverage plan 'covers' the remainder of the permitted expense for the immediate care service. In some instances, an insurance business might not pay anything toward a 'covered advantage'. For instance, if a patient has not yet satisfied an annual deductible of $1,000, and the expense of the covered health service supplied is $400, the patient will need to pay the $400 (often at the time of service). What makes this service 'covered' is that the cost counts towards the annual deductible, so only $600 would stay to be paid by the client for future services before the insurance company starts to pay its share.