Common health insurance definitions (2024)

FAQs

What are some common health insurance terms and their definitions? ›

A claim is a request for payment for services and benefits you received. Coinsurance. The share of health care services paid by an enrollee. Coinsurance is generally found in conjunction with a deductible. Once the deductible is met, the enrollee is typically responsible for a specified percentage of the medical bill.

The proper definition describes medical terminology as language used to describe anatomical structures, procedures, conditions, processes and treatments in the medical field.

One of the most common health insurance options is a health maintenance organization or HMO. This type of insurance provides medical services via a network of physicians, hospitals, and healthcare providers. With an HMO plan, you're required to seek medical services within the existing network.

A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.

Home or property insurance, life insurance, disability insurance, health insurance, and automobile insurance are five types that everyone should have.

Most experts agree that life, health, long-term disability, and auto insurance are the four types of insurance you must have. Employer coverage is often the best option, but if that is unavailable, obtain quotes from several providers as many provide discounts if you purchase more than one type of coverage.

Within the clinical sciences, we use terms to describe findings, diagnoses, diseases, and treatments. Terminology is the discipline of designating terms within a particular field. A standardized terminology provides an established comprehensive set of recommended terms.

Doctors often prefer PPOs because they offer greater reimbursem*nt rates compared to HMOs and have less administrative paperwork. Is a PPO a good thing? For many, a PPO's flexibility and coverage make it a favorable choice, but it comes with higher premiums.

HMOs (health maintenance organizations) are typically cheaper than PPOs, but they tend to have smaller networks. You need to see your primary care physician before getting a referral to a specialist. PPOs (preferred provider organizations) are usually more expensive.

Coinsurance is the amount you pay for covered health care after you meet your deductible. This amount is a percentage of the total cost of care—for example, 20%—and your Blue Cross plan covers the rest.

What is insurance in basic terms? ›

Insurance is a contract, represented by a policy, in which a policyholder receives financial protection or reimbursem*nt against losses from an insurance company. The company pools clients' risks to make payments more affordable for the insured.

premium. The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance.

These days, almost everyone buys level term insurance. The terms “level” and “decreasing” refer to the death benefit amount during the term of the policy. A level term policy pays the same benefit amount if death occurs at any point during the term.

Five factors can affect a plan's monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.

Your total costs for health care: Premium, deductible, and out-of-pocket costs.