Do You Know Your Health Insurance Basics?

Key Health Insurance Concepts:

1. Premium: The regular payment made to an insurance company for health coverage.

2. Deductible: The amount you pay out of pocket before your insurance starts covering costs.

3. Coinsurance: A percentage of the cost you pay for covered services, typically after meeting your deductible.

4. Copay: A fixed amount you pay for covered services, usually for doctor visits or specific medications.

5. Out-of-pocket Maximum: The total amount you pay out of pocket for covered services before your insurance covers the rest.

6. In-Network Providers: Healthcare providers who have contracts with your insurance company and offer services at negotiated rates.

7. Out-of-Network Providers: Healthcare providers who don't have contracts with your insurance company, resulting in higher costs and less coverage.

8. Prior Authorization: Approval required from your insurance company before certain procedures or treatments to ensure medical necessity.

9. Preventive Care: Routine check-ups, screenings, and vaccines covered without cost-sharing to promote good health.

10. Prescription Drug Coverage: Part of health insurance that covers prescription medications, with different plans having various drug formularies.

11. Flexible Spending Account (FSA): A tax-advantaged savings account you can use to pay for qualified medical expenses.

12. Health Savings Account (HSA): A tax-advantaged savings account specifically for medical expenses paired with high-deductible health plans (HDHPs).

13. Dependent: An individual, such as a family member, who is covered under your health insurance policy.

14. Explanation of Benefits (EOB): A statement from your insurance company detailing medical services covered, costs, and any amount you owe.

15. Open Enrollment Period: A specific time each year when you can enroll in or make changes to your health insurance coverage.