Top 10 Insurance Terms to Know
At Trottier Insurance, protecting your family and your assets is our only goal. The more you know about terminology, the better we can serve you. Know what you need, and know what you don’t need, and let us supply your wellbeing. Here are 10 very important terms to identify to ensure success:
- Provider Network – This is also known as being “in-network”. These are groups of medical providers that have contracted with the insurance company to provide health care services. Using an in-network provider can save you money and they will usually accept direct payment from your insurance company. Out-of-network transactions will generally be the more costly option.
- Pre-Existing Conditions – Pre-existing conditions include any injury or illness that you may have prior to getting the insurance plan. The definition can vary by plan so it’s important to check with your plan to see the exact definition. Knowing these conditions and their status is a key component to maximizing your coverage.
- Client Co-Pay – The out of pocket money you must pay before the insurance company begins to pay for your eligible expenses. The answer to the questions, “when does the insurance kick in” concerning eligible expenses? Typically this is required instead of a deductible or coinsurance and requires you to pay a set fee for a specific visit.
- Premium – The amount you pay per billing cycle. The time-tables may vary from plan to plan, but the premium is the amount that you the client pay on a regular basis for your coverage. Generally speaking, the higher your premium, the more coverage you are buying.
- Deductible -The deductible is the amount that you are out of your own pocket before the insurance company will begin paying towards any covered expenses. The deductible affects how much money you will pay out of pocket, and is usually paid at the time of treatment. Depending on the plan, the deductible may be paid annually or once per new condition.
- Once Per Condition – Once-per-calendar-year deductibles are paid once for the entire year and don’t need to be paid again until you renew for an additional year.
- Client Beneficiary – The person or persons who would receive any insurance benefits in case the policyholder was to pass away while on the insurance plan.
- Coinsurance – This is an additional layer of insurance and is a percentage of what the insurance will pay to cover your health care cost after any deductibles or copays have been met.
- PPO – When choosing a preferred provider organization (PPO) plan, your insurer might pay a portion of your bill if you visit a doctor or specialist outside your network. You won’t need a referral from your primary physician to do that, but you’ll probably pay more.
- Maximum Out-of-Pocket – This sets your ceiling You need to know this term and we need to find the best bang for the buck concerning what is the max you can be held accountable for concerning medical billing.
Unsure about another term in your insurance paperwork? Would you like to discuss your needs? Contact Trottier today! We would be happy to sit down with you and determine if your current insurance needs are fully being met.