407 456 5799Frequently Asked Questions
What is a deductible in health insurance?
A deductible is the amount of money you must pay for healthcare expenses before your insurance coverage kicks in. For example, if your plan has a $1,000 deductible, you'll be responsible for paying the first $1,000 of your healthcare expenses before your insurance pays for any additional costs.
What is coinsurance in health insurance?
Coinsurance is the percentage of healthcare costs that you're responsible for paying after you've met your deductible. For example, if your plan has a 20% coinsurance rate, you'll be responsible for paying 20% of the cost of your healthcare expenses after you've met your deductible.
What is a copay in health insurance?
A copay is a fixed amount of money you must pay for certain healthcare services, such as a doctor's visit or prescription medication. For example, if your plan has a $20 copay for a doctor's visit, you'll be responsible for paying $20 each time you visit a doctor.
What is an HMO?
An HMO, or health maintenance organization, is a type of health insurance plan that typically requires you to choose a primary care physician (PCP) who will coordinate your healthcare services. HMO plans often have lower out-of-pocket costs but may have more restrictions on which healthcare providers you can see.
What is a PPO?
A PPO, or preferred provider organization, is a type of health insurance plan that typically allows you to see any healthcare provider you choose, but offers lower out-of-pocket costs if you see providers within the plan's network.
What is a high-deductible health plan (HDHP)?
An HDHP is a type of health insurance plan that has a higher deductible than traditional plans, but often offers lower monthly premiums. HDHPs are often paired with health savings accounts (HSAs), which allow you to save money tax-free to pay for healthcare expenses.
What is a network in health insurance?
A network is a group of healthcare providers and facilities that are contracted with your insurance plan. If you receive care from a provider outside of your plan's network, you may be responsible for higher out-of-pocket costs.
What is a pre-existing condition?
A pre-existing condition is a health condition that you had before enrolling in a health insurance plan. Before the Affordable Care Act (ACA), insurance companies could deny coverage or charge higher premiums to individuals with pre-existing conditions, but this is no longer allowed under the law.
What is a grace period in health insurance?
A grace period is a set amount of time after your insurance premium is due where your coverage will still be in effect even if you haven't paid your premium yet. If you don't pay your premium by the end of the grace period, your coverage may be terminated.
What is an out-of-pocket maximum in health insurance?
What is an out-of-pocket maximum in health insurance? An out-of-pocket maximum is the most you'll have to pay for covered healthcare expenses during a policy period, usually a year. Once you reach your out-of-pocket maximum, your insurance will pay for all covered expenses for the rest of the policy period.