HEALTH INSURANCE TERMS
The percentage of the bill you pay after your deductible has been met.
A fixed amount you pay when you get a covered health service.
Tiered benefit plan
A health care plan featuring multiple levels of benefits based on the network status of a particular provider.
The annual amount you pay for covered health services before your insurance begins to pay.
emergency care services
Any covered services received in a hospital emergency room setting.
SUBSTANCE ABUSE DISORDER SERVICES
Includes behavioral health treatment, counseling, and psychotherapy
A provider contracted by your insurance company to accept an agreed upon payment for covered services.
A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)
Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.
If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.
The amount you pay to your health insurance company each month.
Health care services that focus on the prevention of disease and health maintenance.
Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.
special enrollment period
The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).
A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.