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[choice] 10 Key words health insurance you need to know: know before choosing your insurance plan
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[choice] 10 Key words health insurance you need to know: know before choosing your insurance plan
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cj7blog.blogspot.com - Good knowledge of basic terminology health insurance is essential to choose a health plan to fit your needs and budget. A recent study published in the Journal of Health Economics reported that only 14% of respondents could identify terms of basic health insurance and only 11 % were able to determine the price of a visit to the hospital four days after receiving a hypothetical plane .Since about 48 million uninsured Americans must buy insurance to cover the needs of Obamacare, the lack of understanding about the basic terms can become a big problem. The co -author , George Loewenstein noted that other research has shown that people are very poor choice of health plan due to their lack of knowledge of basic terms . You could end up with a plan that costs a lot, but the benefits you need .
Learn to make the right choice
Here are the top ten health insurance terms you should know when you enroll in a plan through the exchange of health
This is the amount you must pay for your health plan . This amount varies depending on the system and can be paid monthly, quarterly or annually. For example , the average monthly premium is $ 328 for Obamacare. But the amount would go below and above , depending on the type of plan (bronze , silver, gold or platinum and catastrophic coverage ) , state and community .
amount allowed NC Health Choice-Health insurance in North Carolina
Since the maximum amount of insurance provider will pay for their health care services covered . This term is also known as "qualifying expenditure " or " negotiated rate " or "allocation of payments. " Where the provider of free medical care over the allowable amount , you must pay the balance of your account. This is known as balance billing . Suppose that the provider charges $ 200 for a service of health and the amount awarded is $ 150 . provider will charge the balance of $ 50.
deductible
The amount you must pay for covered health services before your plan begins to pay. For example , if your deductible is $ 700, the insurer does not pay for medical services are provided until their costs are more than $ 700.
Co - wage
The co - payment or co - payment is fixed to be paid each time the service is provided with an amount of covered health . The amount will vary depending on the type of service. For example , if your share is $ 20 for an office visit , you pay that amount for each visit. Your plan will cover the rest .
Co -insurance
In a system of health care , you may have to pay a percentage of the amount authorized for service health care , known as co -insurance. You have to pay this amount in addition to your plan deductible and pay the remaining amount authorized . Imagine the amount awarded is $ 200 for a doctor visit and pay co -insurance is 20 %. If you have met your deductible , you will pay $ 40 per doctor visit and your insurance company will pay $ 160.
Inside and outside the network
A provider of health care that has a contract with the insurance company is a network provider , and does not hold a contract of this type is a provider outside the network . Some health plans , such as HMOs do not reimburse for out - of the network and must pay in full for the services of health care. Some health plans cover providers outside the network also . Network copayments, and coinsurance payments are much lower outside the network .
Maximum out of pocket
The ceiling or out of pocket is the more you pay more than the policy ( usually a year) until your insurance company begins to pay the authorized amount. This total does not include premiums, balance rates or fees billed for non-covered services. Some health plans do not include co - payments , deductibles , coinsurance payments out - grid, or other expenses in the amount if you need to know the coverage of your plan. CHIP Program (health insurance for children) and includes Medicaid premiums in this limit. The maximum amount of pocket expenses for a marketing plan for 2014 is $ 6,350 for an individual plan and $ 12.700 for a family plan .
The essential health services
The Affordable Care Act insists that , from 2014 , some health plans ( offered in the individual and small group markets , both inside and outside the market ) should cover a wide range of health care services and services known as essential elements of health. Only thyat insurance policies cover essential health benefits are certified and available in the market . States are also expanding their Medicaid programs to provide these benefits to newly eligible for Medicaid . The essential health services should include products and services for at least the next ten categories
Outpatients
Emergency services
hospitalization
Maternity and newborn care
Addiction services and mental health, including mental health treatment
Prescription drugs
Accommodation and facilities for rehabilitation and adaptation or rehabilitation
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services , including oral and vision care
Preventive Services
The health care services provided to prevent illness , disease, or other health problems are prevention services and include projections , checkups and counseling to patients . Most health insurance plans provide coverage for a series of free prevention services costs , including vaccines and testing. The private insurance coverage in the market for this type of service without coinsurance , copayment, or even meet the deductible plans .
claim
A complaint made to the insurance company after receiving the covered health care services . Typically, health care providers submit to the insurance company for the use of a specialized medical billing claim that prepares and reviews all applications based on the rules and regulations of the plan relevant health care before submission .
Registration is open Obamacare ending March 31, 2014 . Consumers should be aware of the basic terminology for the purchase of a plan of appropriate health care . Verification of patient eligibility for health professionals should include checking all benefits payable , patient data , the number of prior authorization, copayments, coinsurance details, deductibles, patients state policy , dates, type of plan and coverage details , exclusions regime says mailing address, referrals and prior authorization for reimbursement. Professional billing specialist medical billing company have a deep understanding of all aspects of health insurance to ensure the submission of accurate claims for their clients .
source : http://lintas.me, http://merdeka.com
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