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.”

Related Post: ClaimLinx Glossary: Common Health Insurance Terms

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.

Related Post: How Coordination of Benefits Saves Money for Your Employees

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

If I have regular health coverage do I need any other insurance?

Having regular health insurance coverage is a good start. But when examining your overall personal profile, it is best to cover all the bases. ClaimLinx partners with consultants and brokers in the area who also offer products designed to enhance your existing health insurance coverage. Such products include supplemental insurance coverage, long-term care insurance, life insurance, tax consulting, and financial planning.

Related Post: ClaimLinx Glossary: Secondary Coverage

Contact the ClaimLinx sales team today to learn more:

What is a deductible?

A deductible is the specific dollar amount an individual must pay before a health insurance plan begins to reimburse a patient for medical expenses. The higher the deductible, the lower the up-front premium cost for a health insurance plan. The ClaimLinx Simple Option Solution teaches employers and employees how to utilize a health insurance plan for the best possible cost savings.

Related Post: Higher Deductibles Shift Health Costs to Employees

Is my information privacy protected?

Yes. Our employees strictly adhere to all HIPAA privacy regulations. Upon enrollment into the MERP plan, employees are asked to sign a HIPAA release form that ensures ClaimLinx follows all protected health information guidelines related to self-insured health plans. In addition, no proprietary information will be released to your employer without your notification. ClaimLinx maintains all personal information onsite and performs strict electronic security measures. Specific HIPAA regulations can also be found in the MERP document kept onsite through your plan administrator.

Related Post: What Does a Third-Party Administrator Do?

What is a Section 105 Plan?

Section 105 is a part of the U.S. tax code that allows employers to reimburse premiums and/or any health insurance costs tax-free to the employees. This part of the tax code has been around for more than 50 years. Many large companies have implemented a Section 105 plan, but this cost-savings measure is also available to smaller employers. For more information, contact the Internal Revenue Service (IRS) directly or consult your tax attorney. The ClaimLinx Simple Option Solution can show you how to take advantage of tax-free disbursements to your employees to lower your costs.

Related Post: Section 105 Plans After Obamacare