Health Insurance Terms That Might Benefit You

Health Insurance Terms That Might Benefit You

Aug 25, 2022


Health Insurance Terms That Might Benefit You

Choosing the appropriate health insurance plan is crucial. Whatever you decide, you'll have to deal with the consequences. Making the wrong decision can be almost as awful as not having health insurance. Before choosing a new plan, you should familiarize yourself with popular healthcare terminology definitions.


You are still responsible for your medical expenditures even after reaching your year's deductible. In addition, you'll have to pay some coinsurance.

For example, if you reach your $2,500 deductible in May, your subsequent coinsurance rate will be 20%. Thus, you would pay $20, and the insurance company would cover the remaining $80.


Your premium is the fee you pay to the insurance provider for the right to use an active insurance policy. The majority of people make their payments every month. However, you may have quarterly or annual payments.

Fortunately, tax credits can reduce the price of health insurance premiums for plans bought through the marketplace. Your employer likely contributes to the cost of your monthly payment if you get health insurance via your job.


The co-pay is the sum you must pay for a service once your deductible has been satisfied. A $20 office visit or 20% of the covered service may be required. Read the fine print of your insurance. There may be numerous options available in this region.


The deductible is the sum you must pay out-of-pocket for covered services before your health insurance begins to pay for them.

Although a high deductible policy will be less expensive, you might never need the deductible. Therefore, it is something that needs to be well thought out.


You require a reference from your primary physician to receive care from a specialist under a point-of-service (POS) plan. If you see a doctor not in your insurance's network, your medical costs will be higher, but on the plus side, you'll probably have more options for doctors than you would with an HMO.


When you see a physician or specialist outside your network under a preferred provider organization (PPO) plan, your insurance company may cover some of your medical expenses.

Although you'll probably spend extra, you won't require a recommendation from your primary care physician to do it. It would help if you continued using in-network healthcare providers to minimize costs.


A health maintenance organization (HMO) plan may provide little provider flexibility.

However, be ready to foot the entire medical bill if you don't see a doctor who works for the HMO as an employee or on a contract basis (unless there is an emergency). Additionally, you can lose coverage if you relocate or change to a job in a different city.

Bottom Line

Identifying a plan that satisfies your demands and falls within your budget should be possible if you understand the meanings of the vital healthcare buzzwords. Excellent coverage and low cost are typically trade-offs when looking for health insurance.

The highest provider freedom and weakest deductibles usually have higher rates. Conversely, cheap plans can be a fantastic value in a year of good health, but they might be expensive if you have a lot of medical costs. Contact our team at Bell Black Insurance to learn more.