4 Health Insurance Terms To Know

Insurance Blog

When it comes to choosing a health insurance plan, it can be confusing to determine exactly how much you will be paying on top of your monthly premium. There are many terms that are used to describe what you will be paying, but you may not be clear on what these terms mean exactly. Here are four common health insurance terms that you should know that can explain what you will be paying for health services:

  1. Coinsurance: Coinsurance is the amount that you are responsible for paying out of pocket after the deductible and copay amount has been paid. This means that after you have paid both the deductible and the copay and you still have medical costs leftover, you will have to pay some percentage of that determined by your health insurance plan before the health insurance actually kicks in to provide some coverage. 
  2. Copay: The copay is the amount that you pay for certain medical services, such as doctor visits, trips to the emergency room, and prescription fills. Some insurance companies will want you to start paying the copay right away while others will wait until your deductible amount has been paid before the copay kicks in. 
  3. ​Deductible: The deductible is the amount that you pay for your medical services until the insurance that you have kicks in. For example, you will have to pay for all medical services out of pocket up to a certain amount, such as $1,000 before your insurance actually provides the coverage that you have agreed to. 
  4. Out of Pocket Limit: Health insurance companies will almost always provide an out of pocket limit. This limit will ensure that your medical expenses are covered 100% if the expenses exceed the copay, deductible, and coinsurance amount. This protects you from having to pay a huge medical expenses bill when you are going through a medical emergency that requires more care than you anticipated when you originally signed up for health insurance coverage. 

​By knowing some of these health insurance terms, you can be sure that you end up with health insurance that you know you can afford. Not only do you want to keep your monthly premium amount in mind, but you also want to determine how much you can afford when it comes to paying the deductible, copays, and coinsurance. Without keeping these additional costs in mind, you can be paying much more than you anticipated for your health insurance coverage. 

For more information, talk to a company like David Paulson Agency Inc.


12 January 2016