Major Medical Health Insurance Definitions

Common Health Insurance Terms that you have seen but may have been afraid to ask.

Co-Payment: This is the amount of money you must pay for services rendered regardless of co-insurance and the deductible. (i.e. Jim goes to the doctor for a physical and is required to pay a co-payment of $15 for the services rendered.) Get Free Health Insurance Quotes for permanent plan individual or family insurance health plan from local insurance agents.

Deductible: Before the health insurance company will pay for procedures that exceeds office limits, or you are required by your insurance to pay first, you must pay the stated deductible and then the health policy will begin to pay. (i.e. Jim's doctor performs open surgery and the procedure costs $15,000. Jim has a deductible of $500 and is required to pay it before his health insurance pays.)

Coinsurance: You and your health insurance company have agreed to share the cost of paying for procedures up to a certain dollar limit called a Stop-Loss. Once the Stop-Loss is exceeded, your health policy will pick up the bill for covered procedures. (i.e. Jim has a 80/20 % Coinsurance and a $10,000 Stop-Loss. This means that Jim is required to pay 20% or $2000 of $10,000 of procedures in a given calendar year above his deductible. In the above case, Jim pays a $500 deductible and $2000 for his Coinsurance, his health insurance pays $12,500.)