Quick Guide to Health Insurance

  • By interactive
  • 03 Nov, 2017

Health Insurance Terms You Should Know

Health Insurance 101 - A Quick Guide to Terms You Should Know - Quincy, IL

Here at Winters Insurance Group, your premier Quincy, IL health insurance provider, we understand that health insurance is incredibly complicated. If you’re an average family just trying to ensure that your loved ones all remain healthy, it can tough to keep track of all the terminology around health insurance. From deductibles to premiums to Medicaid, health insurance terms are almost like a foreign language. One of the things we do here at Winters Insurance Group is provide a variety of health insurance solutions to individuals, families, and companies around the Quincy, IL area, and thus, we consider ourselves to be experts when it comes to the matter. Here is a list of some of the most common health insurance-related terms that you’re likely to hear.

Payment-Related Terms

Coinsurance: This is the amount that you pay to share the cost of covered services after your deductible has been paid. The coinsurance rate is typically expressed as a percentage. An example of how this works is if the insurance company pays 80 percent of the claim, you pay 20 percent.

Deductible: The amount of money you must pay each year to cover eligible medical expenses before your insurance policy starts paying. For example, if your deductible is $1,000 and you have a medical procedure that costs $5,000, you will only be on the hook for $1,000 (your deductible) of that amount. The remaining $4,000 is covered by insurance.

Out-of-pocket maximum: This is the most money that you will pay during a year for health insurance coverage. It includes deductibles, copayments, and coinsurance. It’s in addition to your regular premiums. Once you exceed this amount, the insurance company will pay all expenses for the remainder of the year.

Premium: The amount that you or your employer pays each month for health insurance coverage.

Health Insurance Programs

Network: The group of doctors, hospitals, and other health care providers that contract with insurance companies to provide services at discount rates.

In-Network provider: A health care professional, hospital, or pharmacy that is part of your health plan’s network for preferred providers.

Medicaid: A state and federally-funded health insurance program that provides health insurance to low-income individuals.

Medicare: The federal health insurance program that provides health insurance benefits to Americans age 65 and older.

Other Health Insurance Terms

Health maintenance organization (HMO): A health care financing and delivery system that provides comprehensive health care services for enrollees in a particular geographic area. With an HMO, you have to use specific, in-network plan providers.

Preferred provider organization (PPO): A health insurance plan that offers more freedom of choice than HMO plans. Members of PPOs can receive care from both in-network or out-of-network providers.

Winters Insurance Group is your trusted source of health insurance in Quincy, IL, so contact us if you need any more information about our health insurance plans.

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