Health Insurance Terms and Descriptions
One of the biggest problems for most people is simply understanding the health insurance benefits they may have. For the most part, health insurance policies try to be user-friendly in their phrasing, but many people are just not really acquainted with medical and insurance terminology.
Most health insurance policies also provide similar to a cheat list which gives the basic outline of coverage and covers the most common medical services health insurance spain for residency. However, you need to be sure that you understand the different things that are ruled out under your plan. Many health insurance plans provide limited benefits for services such as mental health, chiropractic services, and work-related health. Even physical therapy and home health care are often limited to a certain number of visits a year.
A co-payment is a pre-determined amount you need to pay a medical provider for a particular type of service. For example, you may be required to pay a $15 co-payment when you visit your doctor. In this case, you must pay $15 to the doctor's office at the time of the visit. Normally, you are not required to pay any additional fees — your health insurance company will pay the rest. However, in some cases, if your health insurance policy specifies it, you may be responsible for a co-payment and then a share of the remaining balance.
A deductible is the amount of your medical expenses you must pay for before the health insurance company will begin to pay benefits. Most health insurance plans have a calendar-year deductible which means that in Jan of the new year the deductible requirement starts once more. So, if your twelve months deductible is $1500, as long as your medical expenses for the current year do not exceed $1500 the insurance company pays nothing for that year. Once Jan of the new year starts, you have to begin again to pay for $1500 of yours medical expenses.
Coinsurance (or out-of-pocket expense) is the amount or percentage of each medical charge that you are required to pay. For example, you may have a $100 medical charge. Your health insurance company will pay 80% of the charge and you are responsible for the additional 20%. The 20% is your coinsurance amount.
Coinsurance accrues over summer and winter. If you have a large number of medical charges in one year, you may meet the coinsurance maximum requirement for your policy. At that point, any covered charges will be paid at 100% for the remainder of the twelve months.