Health insurance can often be intimidating, which is why you need to know what certain terms mean. Here are some of the most crucial:

  • Allowed amount: This is the maximum that your health insurance plan allows a doctor to charge for payment on covered health care services. It is also referred to as the eligible expense, payment allowance or negotiated rate. Be sure to know what that number is for a procedure you are going to have done before your appointment. 
  • Coinsurance: This term refers to the percentage you are charged of the allowed amount for the health care coverage provided by your plan. The actual number will vary from person to person depending on the type of insurance plan, so knowing yours will be essential.
  • Copay: A fixed amount you are charged for health care coverage provided by your plan. This is the money you will owe after a procedure has been completed, such as a routine visit to the doctor's office for your annual physical.
  • Deductible: The deductible is the amount of money you pay before the plan kicks in at the rate outlined in your benefits summary.
  • Medically necessary: These are the health care services that meet your individual insurance company's standards of what medicine or medical procedure is truly necessary for diagnosis and treatment.
  • Out-of-pocket maximum: The most you will pay before your plan covers 100 percent of your charges.

Whether you choose to go to the home health care route, or visit a local physician, be sure to check back here again for more health insurance help and information, or contact a member of our team to learn more about available options.