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TRANSCRIPT:
Basic Health Insurance Terms
Here are some common health insurance terms you should know: Premium. This is a monthly fee for your insurance coverage. The amount you pay per month will depend on the amount of coverage you have. In some cases, part or the entire premium is paid by your employer. Out-Of-Pocket Expenses. This is the money you pay directly to a health care provider for medical services you receive. Co-pay. This is a flat fee that you generally pay at the doctor's office or pharmacy, usually ranging from $5 to $50. Co-insurance. This is usually a percentage split between you and the insurance plan to share the cost of certain medical services. This split can range from 50/50 percent up to 90/10 percent, meaning they pay for 90 percent of the service and you pay for remaining 10 percent. Referral. This is a grant of permission from one doctor for you to receive additional health care services from another doctor or hospital. Some insurance plans will require a referral to see a specialist. Catastrophic Coverage. This basically covers emergency care and some level of hospital overnight stays. These are generally less expensive than more comprehensive plans that include coverage for services like preventive care.
Sources:
Health Insurance: Understanding What It Covers. Leawood, Kansas.: American Academy of Family Physicians, 2011. (Accessed at June 14, 2011 at www.familydoctor.org.)
Top Things To Know. New York, NY.: CNN Money, 2007. (Accessed October 27, 2009 at http://money.cnn.com/magazines/moneymag/money101/lesson16/index2.htm.)
Torpy, JM. Health Care Insurance: The Basics. JAMA 2007;297:1154.
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