Health care simplified
Get to know the complex world of health care in a way that makes sense to you. A basic understanding of these key words will make it easier for you to navigate your health plan:
- Health Maintenance Organization (HMO) is a managed care plan.
- Point-of-Service (POS) plans combine elements of both a health maintenance organization (HMO) and a preferred provider organization (PPO) plan.
- Network refers to a group of doctors, specialists, urgent cares and hospitals your health insurance company has partnered with to help save you money.
- Primary care provider (PCP) is the doctor you see first for common health concerns and continuing care.
- Specialist is a provider or doctor who has advanced education and clinical training in a specific area of medicine.
- Copay is the fixed amount you pay every time you receive health care services.
- Coinsurance is your share of the costs of a covered health care service.
- Deductible is the amount you owe for health care services before your health insurance kicks in.
- Out-of-pocket maximum is the most you’ll pay for covered benefits in any one year.
- Claim is a request for payment you or your doctor sends to your health insurance company when you receive medically necessary services you want covered.