Health Insurance Jargon Spurs Widespread Confusion

With a language all its own and processes that mystify even veterans of its industry, health insurance is a problem among consumers of all ages.

“People are treating it more like care insurance: you don’t use it until something happens” Kathleen Call, a professor in the University of Minnesota’s School of Public Health, said to Kaiser Health News.

“You have an accident, then you use it. Otherwise you’re trying not to use it. And that’s not the way we want health insurance to be used.”

Make sure you understand how your insurance plan works so you feel confident when using it.

To assist with this, here are five of the most commonly searched words in the healthcare industry along with their definitions.

  1. Deductible – The amount a person owes for healthcare services before future covered benefits are paid. Note, copays and other out of pocket expenses are often not applied toward a deductible.
  2. Copay or Copayment – The fixed amount you pay for a covered healthcare service, typically paid on the date of the service.
  3. Coinsurance – Your share of the costs of a covered healthcare service, calculated as a percent of the allowed, or discounted, amount for the service.
  4. Coverage determination – The decision made by your primary insurance carrier whether a service is covered. Note, your secondary coverage will follow your primary plan’s determinations.
  5. Explanation of Benefits – A statement, either from your primary insurance carrier or from ClaimLinx, with details about what your plan covers, how much was paid, how much money, if any, is still owed and more.

Look for more details on health insurance jargon in the future or contact help@claimlinx.com with any specific questions.

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