Explaining Your Health Insurance And Understanding It

Armen Hareyan's picture
Advertisement

The need for the health insurance and care reform is every growing as the medical insurance coverage is not affordable for millions of Americans. In our daily lives we hear many health insurance terms, such as Benefits, Carrier, Claim, Co-Insurance, Deductible, HMO and so on. But do we know what are they and what they mean?

Knowing the meaning of these basic health insurance terms may help an average individual to better navigatin in his or her search for affordable health insurance coverage plans.

Benefit: This is the amount payable by the insurance company.

Carrier: The insurance company or HMO who offers the plan.

Claim: A request by an individual (you) to the insurance company for the insurance company to pay for services.

Co-Insurance: This is the money paid by an individual (you) when you receive services. This is most commonly referred to as "co-pay".

Deductible: This is how much you have for your health care expenses before your insurance company covers the costs.

Advertisement

Exclusions: Medical services that are not covered by the health insurance plan.

HMO: Health Maintenance Organization: These are your more affordable plans but that lesser costs comes with some limitations. You will have to use plan physicians and not as many procedures are covered as with other types of coverage. This is a good plan if you have no planned expensive surgeries or just want something to help with regular doctor visits. These normally require a co-pay for visits and prescriptions.

AD&D: Accidental Death and Dismemberment is what you get if you are concerned about something happening that can cause you to lose a limb, digit or your life. If your livelihood can be threatened by losing a body part, this type of insurance can help make sure you and your family is taken care of if something were to happen.

PPO: Preferred Provider Organization - This type of insurance allows you to have more freedom to choose your own physician and a greater amount of coverage. The deductible and monthly premiums are higher than a HMO but there is better overall coverage. Most PPO's do not require a co-pay at the time of service.

Pre-existing Conditions: A medical condition that is not covered by an insurance company, because they believe that the condition existed before the individual obtained a policy from the particular insurance company. Many states do not allow for this type of clause to exist any longer.

Provider: The providers are the health care professionals who actually provide the health care services to the patients. It can also refer to a group such as a hospital.

There are, of course, more terms, but this should give you a little help understanding all of the sometimes confusing health insurance terminology.

This story is written by Kelly Guy on behalf of http://www.insuresaver.com.

Advertisement