The process to find a health plan that’s right for you may be daunting, especially when it comes to cost-conscious or first-time insurance shoppers. That’s why understanding the key concepts that make up your plan is important.
Here’s a quick guide to help you decode some of the most common terms.
Premium: This is the amount you and/or your employer must pay for your health insurance or plan every month, quarter or year.
Covered service or expense: The portion of a medical, dental or vision expense that your health insurance or plan has agreed to pay for or reimburse.
Deductible: This is the amount you could owe during a coverage period (usually one year) for covered health care services before your plan begins to pay. An overall deductible applies to all or almost all covered items and services. A plan with an overall deductible may also have separate deductibles that apply to specific services or groups of services.
Coinsurance: This is your share of the costs of a covered health care service, calculated as a percentage of the allowed amount for the service. You generally pay coinsurance plus any deductibles you owe.
Copay: This is the fixed amount you pay for a covered health care service. After you’ve reached your out-of-pocket limit, the copayment is not charged.
Annual out-of-pocket limit: This is the most money you would have to pay for covered expenses in a plan year.
For more help decoding health insurance terms, check out justplainclear.com.
To learn about different health insurance options, please visit uhc.com.