What Does This Mean? Understanding Health Insurance Terms
The deductible is the amount of money that the insured had to pay before the benefits of the policy of insurance may be used. This is usually an annual amount, so when the policy starts, usually after one year would be deductible in force again. Some of the services of doctor visits, can be accessed without meeting the deductible first. Usually there are separate individual deductible amounts and total family deductible.Co-insurance
It is generally a percentage amount that is insured liability. A common fraction is 80/20 co-insurance. This means that the insurer will pay 80% of the procedure and the insured must pay the remaining 20%.
Co-payments
A copayment is a fixed amount the insured must pay at time of service. Usually required for basic doctor visits and the time to buy prescription drugs.
Out of pocket
This is a price to pay for his own pocket. Out of pocket expense can refer to it as many deductibles, coinsurance, or deductibles. Also, when the term annual out-of-pocket maximum is used, which indicates how much the insurance would pay for the whole year out of pocket, at no cost.
Maximum lifetime
This is the largest amount of money from the insurance policy will pay for a lifetime. Watch out for maximum life and maximum lifespan of the individual family, as they may be different.
Exceptions
Exclusions are things that insurance does not cover.
Pre-existing conditions
This is something that someone had before getting insurance. Some plans cover pre-existing conditions, while others exclude them altogether, and in addition, some health insurance plans cover pre-existing conditions after a certain time.
Waiting Period
This is a time would have to wait until certain health insurance coverage are available.
Coordination of Benefits
If the insured has two or more sources to cover the payment of certain conditions, such as insurance coverage for your spouse and your own insurance company will not pay double benefits. In this case, the insurance company would coordinate health services to ensure that each plan pays a portion of the service.
The grace period
This is when you have to pay their health insurance premium after the original due date and before insurance coverage would be canceled.
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