Many people often have trouble understanding the jargon associated with a health insurance plan. Gaining knowledge on health insurance terms indeed goes a long way in helping you understand your insurance plan in detail.
Following are the seven health insurance terms that you should know.
Premiums refer to the amount paid to the insurance provider to avail of the benefits of your insurance policy. The premium amount depends on the chosen insurance plan, sum assured, and age of the insured. You may either make a single premium payment or may make payments on a regular basis, say monthly, quarterly, half-yearly or yearly. You may request health insurance quotes from various insurers and opt for the one offering the most competitive quote with maximum benefits.
Copayment means the out-of-pocket expenses paid by you to the insurance company each time you access a medical service, such as a doctor’s visit or a prescription. While you bear a small part of the medical expenses, your insurance provider will cover the rest. Copayments help to reduce the burden of huge premiums.
Deductible refers to the amount that you must pay from your pocket for medical expenses before your health insurance plan starts to pay. You may identify the deductible amount by contacting your insurance company or viewing the terms and conditions of your policy.
Coinsurance indicates the amount that you have to pay for the covered healthcare service after a deductible has been paid. The main aim of coinsurance is to spread risks among multiple parties. Coinsurance is generally specified as a percentage. This means, in case your insurance provider pays 80% of the claim, you may pay the remaining 20%.
Dependents are the individuals, either child, spouse, or parents who are covered by your health insurance policy. It is important to note that the premiums will be charged based on the number of dependents you wish to cover.
- Network hospitals
Most insurance providers offer cashless benefit to their customers. This means that the insurance provider settles the bills directly with the hospital. In order to avail of such a benefit, it is necessary to be admitted at any of the network hospitals. Such hospitals are part of the insurer’s network of preferred healthcare service providers. You may view the comprehensive list of network hospitals from your Third Party Administrator’s (TPAs) website.
- Group plans
As opposed to personal health insurance plans, group plans offer coverage to numerous members. Such plans are uniform in nature, and hence, offer the same benefits to all the individuals in the particular group.
With a proper understanding of various health insurance terms, you may make smart decisions that may benefit you and your family. It is, therefore, important to understand the features and benefits of various plans and make the best choice. You may either buy health insurance online or visit the insurer’s branch, thereby securing your financial future in case of a medical emergency.