Common Knowledge

Insurance

Individual/Group Plans

Group plan: Join one of the plans of the group (company) that is offered.
Individual Plan: Start by going to an insurance broker, they match various insurance agencies and offer you the most common ones.

Network:  Network of doctors you can use. (e.g. in value you can use 500 doctors, med has 3200 doctors, and care has 4000 doctors that are in contract to an insurance agency.
Rx: related to pharmacy, prescription
Premium: Monthly charge of insurance
Out-Of-Pocket: Money that you have to pay, at any time a kind of charge occurs
Deductible: Money that you have to pay right out-of-pocket for the costs, insurance will usually pay you a portion of the cost of the insured item; reducing the amount of deductible you payed from the over all cost. (e.g. you might have to pay $100 in copayment and 20% coinsurance after deductible with a $350 out-of pocket maximum including deductible.)
Coinsurance: A percentage of contribution to the cost of the insured item up to a maximum amount. done by the insured party or other insurers (other than the main insurer). coinsurance is a percentage payment after the deductible up to a certain limit.
Copayment: Amount paid by the insured person each time an insurance service is used.(a kind of deductible)
The higher the premium the les deductible you have to pay.
moral hazard: Insurance companies use copayments to share health care costs to prevent moral hazard. Though the copay is often a small portion of the actual cost of the medical service, it is meant to prevent people from seeking medical care that may not be necessary (eg: an infection by the common cold). The underlying philosophy is that with no copay, people will consume much more care than they otherwise would if they were paying for all or some of it.

Plan Option

HMO/Plus Plan



HealthSave (health savings account)


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