6 Key Health Insurance Terms You Should Know

Learn how to speak Health Insurance like a pro!


Health insurance is more than just going to the doctor and handing the receptionist your insurance card. There are a lot of factors to consider when deciding what kind of coverage you want, how much you want to pay a month, and which benefits best fit your life.

But health insurance doesn’t have to be complicated. If you know the basic vocabulary terms that go hand in hand with enrolling in insurance, you’ll be well on your way to making the best choices for you and your family.

Here are just six health insurance terms you should know:

  1. Deductible
    If your insurance plan has a deductible, you will have to spend that much money out of your own pocket before your health insurance kicks in to pay its share of medical treatments and care.
    For example, if your deductible is $500, this means that you will have to pay $500 out of pocket before health insurance will start covering your bills. Thankfully, most health insurance plans will cover the cost of preventative care visits like annual physicals, dental cleanings, and vaccinations, before you pay your full deductible.

  2. Premiums
    Health insurance premiums are a monthly fee you pay (or your employer takes out of your paycheck if your insurance is offered through your job) for your insurance coverage.

  3. High Deductible Plan
    A High Deductible Plan is an insurance plan offered to members that typically includes lower monthly premiums, but a much higher deductible members must meet before the insurance begins to cover any medical expenses.

  4. Health Savings Account
    A health savings account (HSA) is a tax-exempt account where members set aside money for healthcare expenses. Most HSAs require you to have a qualified high deductible insurance plan to qualify. HSA funds become available for your use as soon as you make a deposit.

  5. Copayment
    Copayments are straightforward when it comes to insurance. They are an upfront fee you pay to the doctor before you receive care. Some insurance plans may have different fees for copays depending on if you are seeing your primary care doctor or a specialty physician.

  6. Out-of-Pocket Maximum
    Your out-of-pocket maximum is the max amount of money you put toward your copays and deductible before your insurance begins to pay their share. When you meet your out-of-pocket maximum, many if not all your health care services will be covered by your insurance for the rest of the year.

Related article: 3 Benefits of a Health Savings Account

Insurance doesn’t have to be complicated. Getting to know the common vocabulary words and the ins and outs of your insurance company can help you know what to expect and what plans to choose during open enrollment each year.

Any questions? Select Health’s Member Advocates are also readily available to help you find any answers regarding your insurance from questions about your deductible to locating doctors in your area.

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