Question 1

What is a premium?

Accepted Answer

A health insurance premium is the amount that policyholders pay monthly out of pocket for health insurance coverage.

Question 2

What is a deductible?

Accepted Answer

A deductible is the amount you pay for out-of-pocket costs for your covered health care before your plan begins to pay.

Question 3

What is coinsurance?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Question 4

What is a copay and how does it work?

Accepted Answer

A copay is a fixed flat fee that is paid by a patient to their provider before receiving a healthcare service

Question 5

What is an Explanation of Benefits (EOB) and how do they work?

Accepted Answer

An Explanation of Benefits (EOB) is the insurance company’s written explanation regarding a claim. An EOB shows what the insurance company paid, what the member owes, and other helpful information, such as how to seek support. An EOB is not a bill.

Question 6

What's the difference between in-network and out-of-network?

Accepted Answer

In-network means a provider contracted with your health plan, and your health plan provides a higher level of benefit coverage than it provides for out-of-network services. Out-of-network means a provider has not contracted with your health plan, and your health plan provides a lower level of benefit coverage.

Question 7

What is the difference between walk-in clinics, urgent care (including virtual), and the emergency room (ER)?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Question 8

What is coinsurance?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Question 9

What is coinsurance?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Question 10

What is coinsurance?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Question 11

What is coinsurance?

Accepted Answer

Coinsurance is the amount a patient pays for a covered service after their deductible has been met.

Seguro de salud: Términos que debes conocer

Términos clave del seguro que encontrarás al elegir prestaciones sanitarias

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