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Health Insurance Basics

Health Ins Basics:

You should know these terms to understand the details of the potential coverage.

Benefits: the services that your health care provider agrees to cover. Examples of common benefits include preventive care, visits to the doctor when sick, prescriptions and medical equipment. This does not mean that the insurer covers all costs; It may be partially covered.

Coinsurance: Unlike co-payments, which require you to pay an agreed fixed rate, co-insurance requires that you share a percentage of your medical costs with your insurer. The common percentage rates are 80/20 or 70/30, which means that your insurance company will pay 80 or 70 percent of the services, and you will pay the rest. Coinsurance payments are sometimes associated with out-of-network services, many of which will end up being specialized and expensive treatments.

Out-of-pocket limit: Even after reaching your deductible, you can still be responsible for copayments and coinsurance up to your out-of-pocket limit. This means the absolute total that you will have to pay in one year. After this point, the insurance covers all costs.

Health Maintenance Organization (HMO) Plan: A plan that provides coverage and health care services, HMOs will often require you to see exclusively providers and hospitals included in the health network. You will get comprehensive benefits within the network, but less flexibility if you leave the network. And when you leave the network, you probably need a referral from a doctor within the network. Kaiser Permanente, for example, is one of the largest HMOs in the country.

Disclaimer: findhealthins.com is not an insurance company. Once you submit your information, findhealthins.com may instantly match you with local agents who can offer free health insurance quotes based on your requirement and eligibility.

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