Decoding Insurance Terms in Health Savings Plans in NC
When you are in the market for health savings plans in NC, navigating through the health insurance terms used in the package descriptions can be a challenge for many people. To help you better understand your coverage options and policy holder responsibilities, Schnitzer-Slate has created this glossary so you can decode often-confusing insurance language.
Glossary of Common Health Insurance Terms
Coinsurance – Coinsurance is the amount of money that a policy holder is required to pay for health care services after a pre-determined deductible has been met. The amount one pays in coinsurance is usually specified by a percentage. For example, a policy holder may pay 20% toward the charges for a service with the remaining 80% being paid by the insurance company.
Co-Pay – A co-pay, or co-payment, is a predetermined fee that a policy holder pays for health care services. This amount is separate from, but in addition to what the insurance covers. Unlike coinsurance, the co-pay amount remains fixed regardless of the type or level of services provided during the visit. For example, if an HMO has a co-pay requirement of $10, then the policy holder will pay $10 per visit regardless of whether it is a check-up or a sick visit.
Deductible – A deductible is the amount of money an individual must pay for health care services before his/her insurance will start covering a percentage of the costs. For example, if a policy has a $2,500 deductible, then the policy holder will be responsible for the first $2,500 in medical expenses before the insurance will come into effect.
Effective Date – The effective date is the date the insurance policy's coverage begins.
Exclusions – An exclusion is a provision included in many health insurance and health savings plans in NC that prohibits coverage for certain types of damage or conditions.
Guaranteed Issue – Guaranteed issue is a term used when health care coverage is guaranteed to be issued to applicants regardless of their current medical condition, medical history, age or income. This term also guarantees that the policy will be renewed as long as the policy holder makes the required premium payments.
In-Network – When a practitioner or health care facility is deemed "in-network," it means that they are a part of the health insurance company's network of providers and therefore, using in-network providers will usually save a patient more money.
Limitations – A limitation is a price cap that is placed on the benefit pay-out for certain covered expenses. Once a limitation is reached, the policy holder will then be responsible for any expenses related to that particular treatment.
Medigap Insurance Policies – Medigap insurance policies are supplemental insurance policies that are sold by private companies to help cover medical expenses that are not covered by traditional Medicare.
Out-of-Pocket Maximum – An out-of-pocket maximum is the maximum amount of money an individual must pay before his/her insurance policy will start covering 100% of the individual’s medical expenses.
Provider – A provider is a term that is used for health care professionals. While it is usually used to refer to physicians, it can also be used when referring to hospitals, clinics, dentists, chiropractors, physical therapists, and other health care professionals and facilities.
Rider – A rider is a modification to a health insurance policy that either adds or excludes coverage for certain conditions.
Underwriter – The underwriter is the company that issues insurance policies. This is also the company that accepts the premium payments and assumes responsibility for the risk associated with the policy.
Find Affordable, Easy-to-Understand Health Savings Plans in NC
Schnitzer-Slate Insurance Agency offers reliable and affordable Blue Cross and Blue Shield NC health savings plans in NC. Our agents will help you find a plan that best suits your budget and lifestyle. And, you have our word that we'll make sure you completely understand your policy and its coverage options prior to making your final decision.
If you want to learn more about our health insurance plans, or our dental or life insurance plans, just visit our website at http://healthplannc.com/ or call us at 910-392-7020.
Click here for a free rate quote.
When you are in the market for health savings plans in NC, navigating through the health insurance terms used in the package descriptions can be a challenge for many people. To help you better understand your coverage options and policy holder responsibilities, Schnitzer-Slate has created this glossary so you can decode often-confusing insurance language.
Glossary of Common Health Insurance Terms
Coinsurance – Coinsurance is the amount of money that a policy holder is required to pay for health care services after a pre-determined deductible has been met. The amount one pays in coinsurance is usually specified by a percentage. For example, a policy holder may pay 20% toward the charges for a service with the remaining 80% being paid by the insurance company.
Co-Pay – A co-pay, or co-payment, is a predetermined fee that a policy holder pays for health care services. This amount is separate from, but in addition to what the insurance covers. Unlike coinsurance, the co-pay amount remains fixed regardless of the type or level of services provided during the visit. For example, if an HMO has a co-pay requirement of $10, then the policy holder will pay $10 per visit regardless of whether it is a check-up or a sick visit.
Deductible – A deductible is the amount of money an individual must pay for health care services before his/her insurance will start covering a percentage of the costs. For example, if a policy has a $2,500 deductible, then the policy holder will be responsible for the first $2,500 in medical expenses before the insurance will come into effect.
Effective Date – The effective date is the date the insurance policy's coverage begins.
Exclusions – An exclusion is a provision included in many health insurance and health savings plans in NC that prohibits coverage for certain types of damage or conditions.
Guaranteed Issue – Guaranteed issue is a term used when health care coverage is guaranteed to be issued to applicants regardless of their current medical condition, medical history, age or income. This term also guarantees that the policy will be renewed as long as the policy holder makes the required premium payments.
In-Network – When a practitioner or health care facility is deemed "in-network," it means that they are a part of the health insurance company's network of providers and therefore, using in-network providers will usually save a patient more money.
Limitations – A limitation is a price cap that is placed on the benefit pay-out for certain covered expenses. Once a limitation is reached, the policy holder will then be responsible for any expenses related to that particular treatment.
Medigap Insurance Policies – Medigap insurance policies are supplemental insurance policies that are sold by private companies to help cover medical expenses that are not covered by traditional Medicare.
Out-of-Pocket Maximum – An out-of-pocket maximum is the maximum amount of money an individual must pay before his/her insurance policy will start covering 100% of the individual’s medical expenses.
Provider – A provider is a term that is used for health care professionals. While it is usually used to refer to physicians, it can also be used when referring to hospitals, clinics, dentists, chiropractors, physical therapists, and other health care professionals and facilities.
Rider – A rider is a modification to a health insurance policy that either adds or excludes coverage for certain conditions.
Underwriter – The underwriter is the company that issues insurance policies. This is also the company that accepts the premium payments and assumes responsibility for the risk associated with the policy.
Find Affordable, Easy-to-Understand Health Savings Plans in NC
Schnitzer-Slate Insurance Agency offers reliable and affordable Blue Cross and Blue Shield NC health savings plans in NC. Our agents will help you find a plan that best suits your budget and lifestyle. And, you have our word that we'll make sure you completely understand your policy and its coverage options prior to making your final decision.
If you want to learn more about our health insurance plans, or our dental or life insurance plans, just visit our website at http://healthplannc.com/ or call us at 910-392-7020.
Click here for a free rate quote.