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Key Insurance Terms

If you do not understand insurance terms, then it is extremely difficult for you to buy the best insurance plan available for you. Having a basic understanding of insurance terms can make the difference between getting a plan that is affordable and covers most of your medical expenses, or a plan that does not cover much and leaves you paying thousands of dollars in medical bills.

 

Let’s get down to defining important terms:

  • Premium: this is the actual cost of the insurance plan. Remember that, the higher the premium, the better coverage you have; and thus the least you spend on medical bills.
  • Deductible: This is the amount of money you have to pay out of pocket before the insurance company start paying for what is covered.
    Depending on the plan you have, you may have two options of how your deductible will be paid:

    • Once per year: this deductible needs to be paid once per calendar year, and you do not need to pay this again until the next year when you renew.
    • Once per condition: these deductibles are paid each time you visit a doctor’s office, unless it is a follow up for a previous visit.
  • Co-Pay: Similar to a deductible, this is the amount of money out pocket you need to pay before the insurance company starts to pay. This is normally used instead of a deductible or coinsurance. Co-pay requires you to pay a set fee for specific visits.
  • Co-insurance: this is a percentage of what the insurance company will pay to cover your health costs/bills once your deductible or copays have been met.
  • Provider Network: a group of medical providers (doctors, hospitals, etc.) that have a contracted agreement with the insurance company to provide their services. In network providers typically charge less for the given service, than what out of network providers would charge. Using in network providers will usually save you money, and will be less of a haste given the agreement they have with the company.
  • Usual, Reasonable and Costmary (URC): this is the average cost for a given treatment in a given area. Through this price the insurance companies determine how much they are going to cover for the given treatment.
  • Pre-existing conditions: these include any injury or illness that you had prior to enrolling in your health insurance plan. What conditions vary from plan to plan. Given this, remember to check your plan to see whether they cover pre-existing conditions or not.
  • Repatriation of Remains: repatriation of remains covers the cost of returning your body back home in the case of death.
  • Medical Evacuation: provides transportation to the nearest qualified medical facility, not necessarily back to their home country.
  • Beneficiary: this is the person who will receive the benefits in case the policy holder passed away.

 

 

If you have any more questions, contact your local agent, or you can contact our customer service representatives.

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