health science insurance terms

coinsurance
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Terms in this set (10)
coinsurance
The amount you are required to pay for medical care in certain types of health plans
after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For
example, if the insurance company pays 80% of the claim, you'll be required to make a 20% coinsurance payment
copayment
A way of sharing medical costs. You pay a flat fee every time you receive a medical
service (for example, $20 for every visit to the doctor). The insurance company pays the rest.
deductible
the amount of money you must pay each year to cover your medical care expenses before your insurance policy starts paying
Health Maintenance Organization (HMO)
A health insurance plan that allows you to pay a
monthly or quarterly premium in exchange for healthcare services. HMOs require you to work with
a primary care physician who will direct your car and refer you to specialists needed. They also
require you to see doctors, hospitals, and labs within their network of providers.
Health Savings Account (HSA)
A health savings account is a type of medical savings account that
allows you to save money to pay for current and futures medical expenses on a tax-free basis. In
order to be eligible for a health savings account, you must be covered by a high deductible health
plan, not have any other health insurance, and not be claimed as a dependent on another's tax return
Maximum out-of-pocket
the maximum amount of money you will be required to pay each year
for deductibles, coinsurance, and co payments. It is a stated dollar amount set by the insurance company, in addition to regular premiums
Preexisting condition
A health problem that existed before the date your insurance coverage became effective.
Preffered Provider Organization (PPO)
A health insurance plan that allows you to see any doctor
at any time. In addition to a monthly or quarterly premium, a PPO typically requires you to make a
copayment for each service you receive. Copayment for in-network doctors and services are typically lower then copayments for out-of-network doctors and services.
Premium
The amount paid by you or your employer, in addition to copayments, coinsurance and
deductibles, in exchange for insurance coverage.
preventive care
Services designed to keep patients healthy, including check-ups, well baby care
and adult care, immunizations, pap smears, and mammograms.