Help Has Arrived - Understanding Health Insurance Terms

A Insurance Article Contributed by Brandie King

Help Has Arrived - Understanding Health Insurance Terms

Trying to understand the terms used when searching for a health insurance policy is often one of the hardest parts about shopping for one. Below you will find definitions of the most commonly used health insurance terms.

Understanding Health Insurance Terms - C - e Defined

1. Coinsurance - This is an amount of money that you are required to pay by some health insurance plans after you have met your deductible and is usually calculated as a percentage.

2. Co payment - This is the amount of money, usually a flat fee, that you are required to pay by some health insurance plans every single time you receive a medical service, and the insurance company will pay any remaining amount due after you have paid your co payment.

3. Deductible - This is the amount of money you are required to pay before your health insurance company will pay anything on medical bills that you incur.

4. Exclusions - Exclusions are very specific conditions that your health insurance policy will not pay for.

Understanding Health Insurance Terms - h - n Defined

1. HMO - This stands for Health Maintenance Organization. An HMO is a prepaid health plan where you pay a set monthly premium to cover all of your medical needs, but you will have to use medical providers that are on a list your insurance company will provide to you.

2. Maximum Out of Pocket - Your maximum out of pocket costs are the maximum amount of money that you will be required to pay each year and includes deductibles and coinsurance.

3. Non cancellable Policy - A non cancellable policy, also known as a guaranteed renewable policy, is one where you will be guaranteed to receive insurance for as long as you pay your health insurance premiums.

Understanding Health Insurance Terms - p - t Defined

1. PPO - This stands for Preferred Provider Organization. A PPO is where an HMO and fee for service plan is combined into one policy. If you use doctors on the list your PPO provides you then you will be covered for most if not all of the bills. If you use doctors that are not on that list then you will have to pay a much larger amount of the bills you incur.

2. Pre Existing Condition - A pre existing condition is a condition that you had before the effective date of your health insurance policy. Some companies do not cover pre existing conditions at all, and some will cover all or part of the treatment you require.

3. Primary Care Doctor - A primary care doctor is your regular doctor and usually has to be picked from a list provided by your health insurance company.

4. Third Party Payer - A third party payer is any person or company besides you that pays for health care needs. Third party payers can include, but are not limited to, your HMO, your PPO, and the Federal Government.