The healthcare and health insurance world can be confusing! Whether this is the first year you're choosing a health insurance plan for yourself, or you've been in the game for awhile, knowing the basics is helpful.
I’ll be doing a series of articles here to give you some terms to know, basic information, and insight into what to consider while choosing a health insurance plan. The goal is for you to feel more confident in choosing the right health insurance plan. Also, I’ll share some tips and advice for how to get the most out of the insurance plan you have.
Today I’ll be showing you some Terms to Know. These are things you have probably heard of, but maybe don’t know what they are or have a vague understanding. Knowing some of the common terms is a good place to start for a better understanding of your health insurance.
Terms to Know
Premium: This is the amount of money charged by an insurance company for coverage
Deductible: The amount you owe for health care services each before the insurance company begins to pay. Co-pays are designed to help you before the deductible is met.
Co-pay: A copayment, or co-pay, is a fixed amount you pay for a covered health care service. Co-pays are a benefit that kicks in before you meet your deductible. Usually you’ll see this for primary care or specialist office visits or maybe for prescription drugs.
Out-of-pocket maximum: This number is the most you'll pay in medical expenses for the year. After this is met, the health insurance carrier will pay for the rest, except for your monthly premium. This idea of a cost ceiling was instated by the Affordable Care Act.
Network: Group of doctors
PCP: This is a primary care provider; this is a doctor or nurse who you go to for your check-ups once a year or for any general health care needs.
Group or Individual insurance: Group insurance is offered through your employer. Individual insurance is for people who don’t get insurance through their employer.