| There are lots of different kinds of health | | | | providers who belong to the plan. Here are |
| insurance. Plan that cover medical services | | | | a few common terms that you'll probably run |
| and prescription medicines, plans that cover | | | | into: |
| dental expenses, disability insurance that | | | | |
| replaces income lost due to extended illness | | | | Deductible: This is the amount you must pay |
| or injury, long-term care, and so on. In the | | | | out-of-pocket before the insurer will pay |
| United States, people typically refer to the | | | | anything. Deductibles can vary widely, |
| plans that cover medical expenses as "health | | | | ranging from $0 to a few thousand dollars. |
| insurance", and these plans are usually | | | | |
| bought by employers and offered to employees | | | | Co-insurance amount: This is the percentage |
| as part of their compensation, or "benefits". | | | | of your medical expenses you must pay after |
| | | | you reach your deductible. This will |
| Health insurance plans are usually sold once, | | | | typically range from 10-30%. |
| then renewed on an annual basis. So when a | | | | |
| consumer buys health insurance (either | | | | Maximum out-of-pocket amount: This is maximum |
| directly or through an employer), the insurer | | | | amount you are required to pay in a given |
| agrees to pay for health expenses as long as | | | | year, after which the insurer will pay 100% |
| the premiums are paid on time and the account | | | | of the cost of covered medical expenses. |
| is in good standing. | | | | |
| | | | Covered benefits: Types of medical services |
| Health insurance plans come in two flavors: | | | | the insurer will pay for. |
| "Fee-for-Service" or "Managed Care". Both | | | | |
| types of insurance cover major medical, | | | | Exclusions: Types of medical services the |
| surgical and hospital expenses, and are often | | | | insurer will not pay for. |
| referred to as "major medical plans". | | | | |
| Fee-for-service plans pay the medical service | | | | Its true: there's a lot of jargon, and plans |
| provider a fee for each service provided to a | | | | are difficult to evaluate and compare. But |
| patient, and that patient can usually go see | | | | it's important, and worth your time. |
| whatever health care provider they wish. | | | | Carefully review plan descriptions, and take |
| Managed care plans, on the other hand, | | | | your time to understand the coverage of any |
| pre-pay contracted providers for each | | | | plan you're currently under - or considering |
| member's coverage in advance. Members are | | | | purchasing. |
| offered a financial incentive to use | | | | |