facebook pixel Confused By Insurance Terms?
Site Search
< Blog Home < Healthcare and Insurance Basics

Confused By Insurance Terms?

Confused by insurance terms? We've got you covered.

Infographic, key insurance terms everyone should know lg

Related: Health Insurance Terms You Should Know-Part 2 

Premium

Monthly bill you pay (or your employer pays for you) for insurance coverage.

Deductible

You pay this before your plan begins to pay for eligible charges from doctors and facilities.

Copay

An upfront fee you pay to a doctor for medical services. Depending on your plan, this may count toward your deductible.

Pharmacy or RX copay

Upfront fee for certain types of drugs.

Coinsurance

A percentage of charges that you pay a provider or facility after the deductible has been met (commonly 80/20 coverage).

Total member responsibility

After your insurance carrier has paid their portion of a bill (if applicable), you’re left with this amount. It includes copays, coinsurance, and the deductible.

Out-of-pocket maximum

The maximum amount you will pay toward your deductible, coinsurance, and copays. If you meet the out-of-pocket maximum, eligible services are covered 100% for the rest of the year.

 

SelectHealth may link to other websites for your convenience. SelectHealth does not expressly or implicitly recommend or endorse the views, opinions, specific services, or products referenced at other websites linked to the SelectHealth site, unless explicitly stated.

The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.

You May Also Like...

Healthy Living

Called Back After A Mammogram? Here's What to Know

If you’ve been called back for a repeat mammogram, here’s what it could mean.

Nutrition and Diet

100-Calorie Pumpkin Pie Tartlets

Here’s a guilt-free way to have the great taste of pumpkin without feeling like you’re overindulging. It’s a perfect size to snack on by itself or enjoy as a great finish to any meal.

In the Community

How to Cope with Wildfire Smoke

Because fires are still burning in the western part of the country, it’s important to know what to do to protect you and your family.

Business

Why Our Company Culture Sets Us Apart

Here’s why I think creating a safe, welcoming, and supportive culture at work is not only important for our employees, but for the members we serve.

Related Articles

Related Articles

Healthcare and Insurance Basics

Tips for a Better Trip to the Pharmacy

Become a pharmacy patient pro by following these simple guidelines at the pharmacy.

Healthcare and Insurance Basics

Why SelectHealth?

When you want to make a difference in your life, it doesn’t happen all at once. That’s what we mean when we say “SelectHealth is one good choice.” In fact, it’s a good choice that leads to lots of other good choices. And every decision makes a difference.

Healthcare and Insurance Basics

Get Your Medications with Hassle-free Home Delivery

Filling your prescriptions doesn’t have to be a hassle—especially when you can have your medications delivered right to your home.

Healthcare and Insurance Basics

Give Your Baby a Healthy Start by Joining Our Healthy Beginnings Program

Our Healthy Beginnings program gives you the help and support you need for a healthy pregnancy.

Post Author

Bobby Macey

Bobby Macey is a marketer and writer by trade. He’s been published nationally and writes on myriad topics—particularly healthy living.