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Learn to Speak the Secret Language of Your Health Insurance Agent

Have you ever felt like your insurance agent is speaking another language?  I have heard a number of times that people are more confused after a meeting with their health agent than before. To better understand what your choices are in the world of health insurance you need to know what your insurance agent is saying to you. Below is a list of terms that will give you more clarity when meeting with your health insurance professional.

Premium: Your monthly, quarterly, or annual payment for insurance coverage.

Deductible: The pre-set amount of money that needs to be paid before a medical bill will be paid by the insurance company. Deductible amounts vary and is outlined in your policy.

Coinsurance: Generally in any insurance claim after you pay your deductible the insurance company pays a percentage of the bill. Usually the insurance company pays 80% and you pay the remaining 20%. You would see this in your policy as an 80/20 coinsurance.

Maximum Out-of-Pocket: The maximum out of pocket cost that you would pay after your deductible and coinsurance. The maximum out of pocket cost vary from each insurance company.

Co-payment: A small payment to see your family doctor or emergency room visit.

Covered Expenses: The items or services that the insurance company would pay for in the event of an occurrence. Most insurance companies do have limitations on what their policy will cover. Be sure to review your outline of benefits to see what is included in your plan.

Exclusions: Specific items that are not covered in your insurance policy.

Preexisting Condition: A health problem that occurred before you had insurance coverage.

Waiting Period: The set amount of time before a preexisting condition will be covered by your insurance company. The waiting periods vary between insurance companies.

Provider: A doctor, hospital or any other medical professional

Network: A group of doctors and hospitals that have a contract with an insurance company.

Out-of-Network: Any doctor or hospital that is not contracted with the insurance company. Usually, if you see a doctor or go to a hospital that is not within your network the insurance company will pay a different amount. Generally, your deductible is increased and the coinsurance may change from 80/20 to 60/40 or even 50/50.

About the Author: Matt Irons is dedicated to the well being of his clients, by providing peace of mind and helping them find quality health insurance at an affordable price. He cares by giving honest answers and advice to solve your health insurance needs.

Contact: Matt Irons
Phone: 602-573-4198---FAX: 623-691-8033