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Glossary of Health Insurance Terms

If you’re planning to purchase health insurance, you’ll need to understand the different types and cost of plans. If you’re unsure about which plan to buy, read through the glossary to understand what the different terms mean. In this article, we’ll go over Preauthorization, Types of Health Insurance, and Glossary of Health Insurance Terms. Then, you can choose a plan based on your own individual needs.

Glossary of health insurance terms

If you’re a newbie to the world of health insurance, a glossary of health insurance terms can help you understand some of the terminology. From the definitions of commonly used terms to the upcoming changes in non-Medicare health plans, this glossary can help you navigate the complicated world of health insurance. Here are the most important terms and their definitions. Also included are important dates to keep in mind, like the upcoming changes to Medicare health plans and the benefits offered by City workers.

Types of health insurance plans

There are several types of health insurance plans available to consumers. Among these are HMOs, PPOs and POS. HMO plans are similar to PPOs, but they typically use a network of contracted medical providers to reduce costs and maintain high quality care. PPOs may require the insured to see a primary care physician, but they don’t have to pay a deductible for that visit. Moreover, they allow the insured to visit any doctor or hospital that they choose, as long as it is in the network. However, this means that you will pay more for the services of a provider outside of the network.

Costs of health insurance

The cost of health insurance continues to climb, even with a slowdown in employer-sponsored plans. In 2016, the average increase in employer-provided premiums and deductibles surpassed the growth in the median income, rising to 11.5 percent for middle-income people versus 7.8 percent in 2008. In 2018, premiums and deductibles were more than 10 per cent of median income in 42 states, with the highest increase in Louisiana and Mississippi.

Preauthorization

Delays in obtaining prior authorizations can disrupt normal administrative workflows. Some practices even add staff to handle prior autos. In addition to taking time from office staff and clinicians, these processes also put pressure on the payer. When payers withhold reimbursement after a treatment, providers are left with the challenge of pursuing unpaid revenue from patients. If these expenses are not recouped within a reasonable time frame, they may end up being written off as bad debt.

Deductible

In the first year of your health insurance policy, you will pay for many health care services, such as doctor’s visits and urgent care. You will also pay for any tests or MRIs. Once the deductible is met, you will be reimbursed for these services. However, you should consider that these high-deductible plans can be expensive. It is important to compare the cost of health insurance plans to ensure you are not putting your health at risk.

Coinsurance

Coinsurance in health insurance refers to sharing the costs of hospitalization. It is an option that you can choose when purchasing or renewing your health insurance plan. It can help alleviate some of the financial burden when your first policy has been used up. The cost of coinsurance is typically a percentage of the total bill. You can choose a higher percentage than the one you’re used to if you want to save money in the long run.

Copayment

A copayment is a set amount that a health insurance plan requires a person to pay for a medical service. Many health plans waive the copay if you only need to visit a primary care physician a few times a year. After that, you will be responsible for the full cost of healthcare services. Coinsurance, on the other hand, is a percentage that you and your insurance carrier split. Copayments can be as low as a few dollars or as high as several hundred dollars.

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