Health Maintenance Organization. HMO’s are popular health benefit programs in which you’ll pay monthly premiums in return for managed coverage for your checkups, hospital stays, doctors’ visits, surgery, emergency care, preventive care, lab tests, and X-rays. If you join an HMO, you will have to select what’s called a “Primary Care Physician” who will be…
DetailsHealthcare facilities or providers who are members of your health plan.
This is a payment system for healthcare where your provider is paid for each service after it is performed. You receive reimbursement after you file a claim.
This refers to the date on which your insurance coverage will actually begin to cover you.
A specific circumstance or condition that is not covered by your policy.
The amount you’ll be required to pay for healthcare expenses before your insurance plan will begin to reimburse you.
The various medical procedures that your insurer has agreed to provide you coverage for.
This acronym refers to the Consolidated Omnibus Budget Reconciliation Act of 1985. The law requires group medical plans covering twenty employees or more to offer participants the option to receive continued healthcare benefits for up to eighteen months after the cancellation of their group plan.
The amount you will be required to pay for a particular medical expense. Coinsurance is measured as a percentage of the total medical bill.
This is a cost-sharing arrangement in which you will be responsible for a specific charge for a specific medical service ($20.00 per office visit, or $10.00 per generic prescription).
