1.You go to hospital or doctors office.
2. They run your insurance and tell you a co-pay, so you pay the co-pay $
3.They send the bill to the medical or dental insurance $
4.The medical insurance decides only pay a portion of what they said they would pay
5.Hospital or doctor office then sends you a bill to pay $
6. You pay for the medical insurance $

It's the greatest scam in American history. You paid 4 times for one service, You pay for the insurance, co-pay, your insurance pays in the third part but it sends your rates up so you pay more, then you pay again because they don't want to pay for the price they promised.