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Health Insurance Glossary

Here are some of the most common terms you will encounter when selecting and using health insurance:

Premium-the amount you and/or your employer pays for health insurance. It can be paid monthly, quarterly or yearly.

Deductible- the amount of money that must be paid out-of-pocket for a health care service before an insurer will start to pay

Co-payment- a fixed amount you pay when receiving a health service, such as a doctor visit or to receive prescription drugs

Co-insurance- the percentage an insured person pays for a service after a deductible is met. Your insurance pays the rest.

Network- the hospitals, physicians and other health care providers your insurance has contracted with to provide health care services.

HMO (health maintenance organizations)- managed care plans that have a closed network of providers you can visit. Most HMOs require you to have a primary care physician who will refer you to a specialist if needed.

PPO (preferred provider organization) –­ managed care plans that allow you to visit any doctor from a preferred network of hospitals and physicians. Under PPOs, you can visit a doctor out-of-network, but you will be charged more.

Out-of-network—health care providers not contracted to provide services to customers on a particular health plan

Out-patient-a person who visits a hospital or clinic for medical services but does not require an overnight stay

Inpatient-a person who is admitted to a hospital for at least one night for ongoing care

Mental Health Care-the diagnosis and treatment of mental illnesses, such as depression

 

How Much Will Your Health Care Cost?
What Are Medicare and Medicaid?
Paying for Prescription Medications
Health Insurance: Glossary of Common Terms
Getting Health Insurance