Health insurance is necessary as it can provide you with access to affordable medical care. Despite its importance, choosing your health insurance and navigating the process can be really overwhelming. The prices, coverage options, and insurance terms can be confusing. Feeling overwhelmed by the process should not deter you from choosing your health insurance so you can have peace of mind that you are covered. Below you will find a helpful guide for key health insurance terms.
Guide for Key Health Insurance Terms
Every insurance plan is different, including the cost and type of coverage. The following terms can help you successfully navigate choosing and utilizing your health insurance coverage.
Premium:
Premiums are the amount paid periodically to the insurance company to maintain coverage. This can be paid monthly or annually.
Deductible:
A deductible is the amount you need to pay out of pocket for covered medical expenses. Your deductible must be met before the insurance company starts to contribute.
Out-Of-Pocket Maximum:
An out-of-pocket maximum is the amount an individual is required to pay for covered medical expenses during a specific period. This is often annually. Once the out-of-pocket maximum is reached, the insurance company covers 100% of any additional expenses for that year.
Copayment:
Often referred to as a “copay,” a copayment is a fixed amount you have to pay at the time you receive certain healthcare services. Services often include a doctor’s visit or prescription medication.
Network:
You may hear the phrase “in network” when discussing providers. In-network refers to the group of healthcare providers, hospitals, and medical facilities that have an agreement with your insurance company. This means that they have an agreement to provide services at negotiated rates. Alternatively, a provider or hospital that is not in your network will often be much more expensive, including higher out-of-pocket costs.
Exclusions:
Unfortunately, everything is not covered by insurance. With that, when shopping for plans it’s important to determine what isn’t covered. Exclusions in your insurance include medical services, treatments, or conditions that are not covered by the insurance plan.
Preauthorization:
This is a requirement to obtain approval from the insurance company before receiving certain medical treatments or services. Preauthorization is used to ensure the treatments or services you want or need are medically necessary. In general, cosmetic treatments and procedures are not covered by general health insurance.
Types of Health Insurance
Health insurance coverage can feel overwhelming. You may wonder what type of coverage you should get, how much you should spend, and who it will cover. Consider the following types of insurance as you navigate choosing your coverage.
Individual Health Insurance Plan:
An individual insurance plan is a health insurance policy that provides coverage to a single person. This is different from a group or family plan as it offers personalized protection and benefits. This is why it’s important to choose an individual plan that is tailored to your unique healthcare needs.
Family Health Insurance Plan:
A family insurance plan is a health insurance in Los Angeles policy that provides coverage for multiple individuals. This is often a family plan, including the primary policyholder and their dependents. Still, a family health insurance plan offers comprehensive health care for your entire family.
Group Health Insurance Plan:
A group health insurance plan is a policy that is often provided by an employer that offers coverage to a group of individuals. This type of plan provides collective healthcare benefits that are at a lower cost as compared to individual plans.
Professional Insurance Brokers
If you need insurance coverage, consider Safecal Insurance Services. They offer a wide variety of options to meet any of your personal or professional needs. Safecal professional insurance brokers near you in LA offer business, home, commercial property, personal auto, life insurance, limo insurance, vapor shop insurance, and health insurance. Contact their team today for any of your health insurance needs!