Health Insurance Terminology - What Does it All Mean?

How can you make the best decision for you/your family’s health insurance needs without knowing at least the basics? We want you to feel comfortable with making these important decisions, so the following are basic health insurance terms everyone should know. It will help you better understand your coverage and what expenses to anticipate when using the benefits of your health insurance coverage.

Deductible: The amount you owe for health care services your plan covers before your plan begins to pay. 

Co-payment:  A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. Many plans have co-payments for services that are covered before your deductible is met.

Co-insurance: Once your deductible has been met, your share of the costs of a covered health care service is calculated as a percent (for example, 20%) of the allowed amount for the service. 

Maximum Out-of-Pocket Limit: The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges, or health care your plan doesn’t cover

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