- Why Do I Need Health Insurance?
- What to Look For in Healthcare
- Saving Money On Healthcare
- Blue Cross Blue Shield Plans
- Why Blue Cross Blue Shield?
- Health Savings Accounts
- Short Term Plans
- Dental Care
- Insurance For Students
- Insurance For Small Business
Glossary Of Insurance Terms
Agent – A licensed professional who helps people choose the right insurance policy for their needs. Agents can help you determine what kind of coverage you need, find a policy to meet your budget, and can walk you through the application process.
Beneficiary – A person who receives the benefits of an insurance policy. It’s a common life insurance word, and refers to the person who will receive the payout if the policyholder dies.
Coinsurance – Coinsurance is the percentage of a medical bill that you are responsible for paying. For example: if you have a medical bill for a surgery and your coinsurance is 80%, your plan will pay the 80% and you will pay 20% of the bill.
Co-payment – A co-payment is the fixed dollar amount of a medical bill that you are responsible for paying. For example: if you visit the doctor, you pay $20 to the doctor, and your plan covers the rest. The $20 is your co-payment.
Deductible – The part of the medical bill a patient must pay before the insurance coverage begins. For example: if your deductible is $1,000 and you have a hospital bill of $5,000, you pay $1,000 and your insurance coverage will start for the remaining $4,000.
Exclusions – An exclusion is any medical condition or treatment that is not covered in your insurance plan.
Generic Drugs – Generic drugs are manufactured by different pharmaceutical companies and have the same standards of quality that popular brand name drugs have, with the same active ingredients. And because almost no money is spent on marketing and advertising them, they cost much less than name brand drugs.
Health Maintenance Organization (HMO) – A managed care organization that makes an agreement with a “network” of health care providers to lower medical rates in exchange for patient referrals. An HMO differs from a PPO because it requires members to use healthcare providers in its network. HMOs also tend to be less expensive.
Health Savings Account (HSA) – A tax-free savings account set up by an employer’s fringe benefits program or the patient themselves to use for medical expenses only.
Indemnity – A payment for damages, injuries, or losses.
Long Term Care – Those with chronic sicknesses and/or disabilities that are given care for significant periods of time. Long term care includes therapeutic and recovery care, nursing home care, and assistance with daily tasks.
Managed Care – It’s a type of healthcare system that offers affordable health insurance and uses efficient medical practices to provide mutual benefits for plan members, healthcare providers, and the insurance company.
Medicaid – A health insurance program for those with limited incomes and low resources.
Medicare – A health insurance program that helps pay for medical care for people over 65 years of age.
Medigap – Also called Medicare Supplement, it’s a supplemental insurance policy to help cover gaps in current Medicare Parts A and B coverage.
Network – A group of individual doctors, hospitals, and other healthcare providers that contract with a managed care organization such as a Preferred Provider Organization (PPO) or a Health Maintenance Organization (HMO).
Out-of-pocket expense limit – The maximum amount of money you will pay out of your own pocket per year for medical expenses under your insurance plan.
Preferred Provider Organization (PPO) – A managed care organization that makes an agreement with a “network” of healthcare providers to lower medical rates in exchange for patient referrals. A PPO differs from an HMO because it offers coverage with healthcare providers outside of the network.
Premium – The monthly rate that you pay to your insurance company to stay covered.
Pre-existing health condition – A prior health condition that you had before your insurance coverage started.
Primary Care Physician – A general care doctor. Primary Care Physicians are usually family practitioners, pediatricians, internists, and OB/GYNs. These are the physicians that a managed care patient goes to first for general care, and then can receive specialist referrals from if needed.
Term – The specified amount of time that your insurance policy will cover.
Term Life Insurance – A life insurance plan that will cover a life for a certain period of time.
Waiting Period – The time an insurance company makes you wait before your coverage starts. The reasons for a waiting period could be a pre-existing health condition or other approvals needed.
