The insurance industry is full of terms that many people find confusing. Especially since most of us won’t have a lot of contact with these terms, unless something goes wrong and we need to file an insurance claim. Here are a few common insurance terms that you’ll encounter when dealing with health insurance, and what they mean.
Co-payment– a co-payment is a fee that a provider is allowed to charge to a patient for services rendered. For instance, when you go to your doctor to have your sore throat checked, you may have to pay a co-payment for the visit. However, many plans do not charge co-payments for wellness exams. Generally, co-payments are in addition to any deductible you may have to pay with your plan.
Deductible – a deductible is an amount that you must meet before the plan will pay benefits. For instance, if you have $1000 deductible, you must have $1000 of qualifying expenses out-of-pocket before your plan coverage kicks in. Generally, the larger your deductible, the lower your monthly premiums.
Usual reasonable and customary – this term is used to describe what the normal cost is for a medical procedure in certain area. If your healthcare provider charges more than the usual reasonable and customary fee for a procedure, your insurance may require you to pay the difference.
When you are shopping for a California health insurance plan, you may find that there are many terms in the plan description that you don’t understand. Please feel free to call Benefit Packages at any time if you need clarification on a medical insurance plan description. We are here to help you choose the best health insurance for your lifestyle.