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Craig Read

Health Insurance Lingo Explained


By: Health Insurance
Submitted: 2009-12-28 16:00:34 | Word Count: 441


When searching for health insurance you must have a good understanding of health insurance lingo. After all, you can’t be sure you are getting the best insurance and the most adequate health insurance coverage for both you and your family if you don’t understand the policy.

There is no reason why you should be confused when you read your health insurance policy. Make it a point to understand commonly used terms in the health insurance field and if you don’t understand something, contact your health insurer for an explanation.

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So, what are you waiting for? Pull out that health insurance handbook and start learning about your policy!

Common Health Insurance Terms to Know

* Deductible - A deductible is the amount of money that you must pay out of pocket before your health insurer begins to pay out benefits. Deductibles are usually calculated on an annual basis, meaning that your satisfied deductible amount starts at $0 every year. Some services, however, in your health insurance policy are covered without the need to meet the deductible, such as annual checkups and doctor visits. Pay close attention to your deductible details if you have a family, as often times each member of the family must meet their own deductible before the insurer begins paying for benefits.

* Co-Payments/Co-Insurance - Co-payments, often referred to as co-insurance, are amounts that must be paid for receiving care or prescription benefits. There are typically different co-payments for emergency room visits, doctors’ visits and prescriptions, so take the time to educate yourself about your co-payments so that you can be prepared to pay at the time of your next doctor or emergency room visit.

* Lifetime Maximum - Many consumers are simply unaware of their policy’s lifetime maximum; however, it is important to understand that a lifetime maximum is the maximum amount of money you can spend on healthcare during your lifetime; exceed that amount and you are not covered.

* Pre-Existing Conditions - If you are switching health insurers and you have an existing medical condition, be aware that many health insurance companies will not cover your “pre-existing medical condition.” Some plans cover pre-existing medical conditions; some plans cover them after a certain grace period has elapsed; and some simply don’t cover them at all. Make it a point to thoroughly understand pre-existing medical conditions before switching health insurance.

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