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Coinsurance
- A percentage of your health-care costs that your insurance does
not cover and you have to pay.
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Deductible
- The amount of money you are required to pay first before your health
insurance plan starts paying.
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Copayment
- A set dollar amount of money you may be asked to pay for a doctor's
visit.
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Out-of-Pocket
Maximums - The plan will set a total amount you are required to
pay (usually the total of your deductible and your coinsurance) for
health-care costs in one year, at which point your plan will pay 100%
of eligible costs.
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Providers
- Any health-care provider or group of providers, such as a doctor,
physician group or hospital is called a provider.
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Generic - A drug that is exactly the same chemically as a brand-name drug,
and usually lower in cost.
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Indemnity
Plans - An indemnity plan reimburses you for your medical expenses,
regardless of who provides the service. In some situations/types of
coverage, this amount may be limited.
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Guaranteed Issue - A simple explanation of the term Guaranteed Issue means that the insurance company will issue this policy without asking any health or medical history questions. This type of health insurance plan, in most cases, will cover pre-existing medical conditions after the insurance is in effect for 12 months. However, if the person to be insured has had previous health insurance coverage, within the last 63 days, under a HIPAA qualified health plan, the 12 month wait period will be waived.
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HIPAA - The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services (CMS) website, Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs.
