What do all these crazy insurance terms mean?

You may have received a bill from your recent visit and have some questions about what insurance is doing. There might be some verbiage on the statement that almost looks like a foreign language to you. Well, we are going to clear some of the confusion up for you. Listed below are some of the common terms that insurance companies are using.

Deductible: Amount of loss that the insured person pays before the insurance kicks in and pays

Copayment: A predetermined, flat fee an individual pays for health-care services, in addition to what insurance covers

Coinsurance: A percentage of each claim above the deductible paid by the policyholder. An example for a 20% healthcare plan would mean that the insured party would pay the deductible amount plus 20%

Coordination of Benefits: A system used in group health plans to eliminate duplication of benefits when you are covered under more than one insurance plan

Effective Date:  The date on which a policyholder’s coverage begins

Pre-existing Condition: A health problem that has been diagnosed, or for which you have been treated, before buying a health insurance plan

These are some of the common terms that are seen when processing the payments from the insurance companies. Hope this clears up the confusion that can come with understanding the statements coming from your insurance company.




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