Important Health Insurance Terminology

When it comes to health insurance terminology, many of us Americans are in the dark. Please read more to find answers to some of your questions about healt…

When it comes to shopping for health insurance, the hardest thing to understand in most cases is the terminology. Once you begin to develop and understanding of the general terminology, it will assist in further understanding the product you are potentially going to purchase. Here are some of the most commonly used terms and their general definition so you can understand then better.

First to connect you with the world of insurance you have to become a subscriber. The subscriber is the individual who is insured. The subscriber is responsible for a few things, first being the insurance premiums. The premium is the cost to have the policy, and is normally paid by a week, month, or year-to-year basis. This is no different from a car note, rent or mortgage. The subscriber is also responsible for the deductible, which is the amount of money to be paid before the insurer begins to pay. One thing to remember is that in many cases the higher the deductible, the lower the premium. Another thing the subscriber is responsible for is the co-pay. This is a certain amount that the subscriber will have to pay at the time of service, which is normally seen with HMO and PPO health insurance plans. An example of this would be when you go to have a routine check-up with your doctor, depending on your health insurance plan you could expect to see a co-pay at the time of your visit.

A preexisting condition is something that many people have to deal with when it comes to health insurance coverage. This is a medical condition or injury that has occurred prior to the beginning of the policy. These can be tricky and the requirements that come with them are very detailed and strict. It is important to understand these things if and when it does apply.

As a subscriber you should be mindful of out-of-pocket expenses which you will be responsible for. These are medical expenses that are not covered by the policy and are in addition to the premiums which are already set. These however do include but are not limited to deductibles, co-pays, etc.

You will also need to be aware of in-network and out of network providers. In-network providers are providers which are listed and contracted with the insurance company. For this reason, they will provide services to you at a reduced rate. On the other hand, out-of-network providers are the opposite. They do not have a contract with your insurance company and therefore will still provide services but it will cost the subscriber more at the time of the visit.

There are more terms to go with these but these will give you a great start at understanding the wealth of information insurance policies will pile on you.