Health insurance is confusing enough without murky terms like deductible, copay and, coinsurance. The good news is that we have the 411 on these and other basic health care network terms, so watch this video, then sail through every insurance issue.
As if health care weren't already confusing enough, it also comes with its own totally baffling lingo. When discussing insurance, perhaps the most commonly confused term is a plan's “deductible.” A deductible refers to the amount that you need to pay on your own before your insurance will kick in and cover your health care costs. The most important thing you need to know about your deductible, is that it usually resets every year.. So, if you had a $1,000 deductible and spent $5,500 total in health care this year, your insurance would only provide coverage against $4,500 of your total costs. Deductibles are not usually applied to basic health care, such as visits to your primary care physician and gynecologist. Instead, they are often used when you visit a provider who is not on your health insurance's list of approved doctors. Approved doctors are usually referred to as “in-network,” and are chosen by your health insurance provider. Similarly, “out-of-network” doctors are those that your health insurance will not pay for entirely, or at all. Another confusing term, “pre-existing conditions,” refers to any health condition that you were already been diagnosed with prior to selecting your insurance. Whether or not additional costs related to a pre-existing condition will be covered by your new insurance depends on a number of factors, including what condition it is, whether you are currently covered by health insurance of some kind, and the type and quality of your new insurance. If you do have a pre-existing condition, you should make sure that you understand how your new insurer will treat ongoing costs related to it. Another term to be familiar with is an “exclusion,” which is when your insurance company will not cover a health care service. While these are just a few of the commonly misunderstood terms you'll find in your insurance plan, understanding these concepts will make it a lot easier to understand what's covered - and what's not.
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