From deductibles to copayments: the terminology of health insurance is explained.
Health insurance helps you stay well and cover your costs when you are sick or injured. But what do the particular words used by insurance companies and providers mean?
To help you gain a deeper understanding, here are some simple explanations of the most commonly used terms.
- Premium: Like car and home insurance, health insurance requires you to pay monthly to make sure your coverage is not interrupted. This is called thin. The size of the premium varies depending on your plan choice and is usually reset each year.
Cost sharing: This general term refers to medical or pharmacy expenses that you pay in conjunction with your insurer. Some health plans require cost sharing and others do not. It just depends on the plan you have. Types of cost sharing include:
- Deductible: This is the dollar amount you earn each year before your insurer starts paying for covered services. Once you have completed the deductible, the plan will cover your costs.
- Co-insurance: Some insurance plans require you to pay a percentage of certain medical costs while paying the rest. This is called co-insurance.
- Co-payments: These are flat rates that you give to participating providers when you receive treatment in their office, urgent or emergency care, or when you get other supplies or services, such as prescription drugs or screening tests.
- Pocket maximum: This is a maximum dollar amount set by your insurer that you will pay in one year. When the deductible, coinsurance, and copayments you have paid add up to your annual pocket maximum, your plan will pay the rest (excluding the premium).
To make sure everyone can get the help they need to stay healthy, organizations like Molina Healthcare offer a wide range of plans at different prices, all with access to quality care.
We hope these explanations are helpful. Do you still have questions? Rely on Molina. Feel free to check out our website at MeetMolina.com for more information.
Exemption from liability
Molina Healthcare Inc. has posted this content to May 24, 2021 and is solely responsible for the information it contains. Distributed to the public, unpublished and unalterable, the day May 24, 2021 3:40:02 PM UTC.