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Common Health Terms to Know

Guest post by: John Clark

Article Overview: With the current debate regarding health reform still raging on more and more Americans are struggling to understand their rights and benefits currently available in the world of health insurance. Trying to make sense of the plethora of insurance jargon is just one more blockage toward getting a better comprehension of health insurance.

Common Health Terms to Know

With the current debate regarding health reform still raging on more and more Americans are struggling to understand their rights and benefits currently available in the world of health insurance. Trying to make sense of the plethora of insurance jargon is just one more blockage toward getting a better comprehension of health insurance. The terminology used by health care insurance professionals can be difficult to understand and sometimes these terms weigh down the ability to properly comprehend an individual policy and the benefits and restrictions within that policy. Below is a glossary of common health insurance terms that can help facilitate the development of health insurance awareness, knowledge, and help health insurance consumers as hey navigate through the sometimes cloudy waters of health insurance policies.

• Coinsurance – This refers to the amount that the policy owner is required to pay for during a medical exam or procedure after the owner has met their annual deductible. The coinsurance rate is expressed as a percentage. For example: many health insurance companies provide coverage for 70% of the health claim, leaving the policy owner responsible for the remaining 30%.

• Customary Fees – Health insurance companies have something known as reasonable fees for medical services provided within a specific area. For example: if you go to the doctor for a sprained ankle and the doctor charges $2000 for the service, where other physicians may only charge $800, you will be assessed the $1200 difference. Be very aware of these types of costs because they can cause your out-of-pocket expenses to sky-rocket. This can be addressed through a request to your medical provider asking for their acceptance of the medical insurance payment as a total payment for the service.

• Deductible – This is the set money that the policy owner will have to pay during each annual plan before the health insurance company begins to pay on the expenses associated with the specific health policy.

• Co-payment – This refers to the policy owners’ share of the medical cost. There is usually a flat fee charged for every medical service the policy owner participates in. The health insurance company pays the rest. For example: during a normal doctor’s exam, the policy owner would pay a co-pay of $30. The insurance company would cover the remainder of the costs.

• Coordination of Benefits – This is a system that is meant to eliminate any benefit replication when the policy owner is covered under more than one group health insurance plan. Benefits under the two health plans are normally restricted to no more than 100% of the total health claim.

• Covered Expenses – In most cases, health insurance plans will not pay for all health care services. Whether the insurance is a HMO or PPO, some may not provide coverage for prescription drugs, while others may not provide coverage for behavioral or mental health care. The covered expenses are those costs that the health insurance company has agreed to cover or pay for.

• Exclusions – These terms refers to particular conditions or situations in which the company will not cover. Be especially aware of these exclusions while going over your specific policy.

• Maximum Out-of-Pocket Expenses – This refers to the absolute maximum money that the health insurance company requires the policy owner to pay out for various expenses, including co-payments, coinsurance and annual deductibles.

• Non-cancellable – This term refers to the specific assurances granted by the health insurance company to the policy holder that certifies insurance provision as long as the policy owner maintains their specific premiums.

• Premium – This term refers to the amount of money paid in order to have an active insurance policy

• Pre-existing Condition – This term refers to a chronic illness or medical condition you have been previously diagnosed with, in most cases before the health insurance coverage was active.

There are a variety of medical and health insurance terms. Most of the terms and vocabulary can be assessed and gone over with an insurance broker or representative, however, always be diligent in your own research and check into terms that are confusing or seem contradictory. Many of these terms can be easily gone over on the Internet. Before you sign up for any form of health insurance, be aware of the terms and remain educated on how they affect your specific health insurance plan.

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Article Tags: health care, Health Insurance, health insurance, Health Reform
Referred by: http://www.franchisefix.com/



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