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Understanding health insurance terminology

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October 6, 2013

Last week we saw the beginning of enrollment and application for health coverage under the new Patient Protection and Affordable Care Act.

The Act was signed into law on March 23, 2010 and brings a significant change for our country.

The Act established state-based health insurance exchanges where individuals can purchase health plans as of October 1st of this year.

For many citizens, this is the first time that they will be sorting through a menu of health plans and cost decisions.

The national website "healthcare" is the best starting place to provide valuable information.

Along the way, trying to understand the terms and features of a plan are very critical before you make a decision.

So lets review some of the insurance terminology:

Co-payments: is a fixed amount that you pay at the time of the service, such as $15 for an office visit.

Deductible: is a specific yearly amount that you must pay before your health plan starts to cover all or part of your healthcare expenses. Some plan may have a deductible amount of $500.00, so you pay the first $500 before the plan cover any remaining amount.

Open enrollment-is a period of time in which you are allowed to select your health plan. The Affordable Care Marketplace enrollment is open till March 31, 2014 and then another open enrollment will begin in October 2014.

Out of pocket costs is the amount that you pay for such items as deductibles, copays and services that are not covered

Pre-existing condition: a health condition that exists prior to enrollment in a health plan. The Affordable Care Act provided that you will not be turned out for health coverage or treatment due to prior illness or conditions.

Premium is term for the cost or fixed amount that you will pay (monthly or annually) for your health plan. This amount will depend on the number of people covered by the plan and the type of plan selected.

Take the time to research your health care decision and the medical needs of your family. Review your budget and the medical expenses that you incurred for the past year.

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