Category Archives: Health Insurance Glossary

Deductibles | Copay’s | Co-insurance | & Maximums

By on August 8 2013 | | Leave a comment

A Question that is often asked is, with regard to health insurance policies is  how do deductibles, copay’s,co-insurance & out of pocket maximums work? Here’s a short 3 minute YouTube video from Humana on this subject: Deductibles and Coinsurances If you have additional questions call the health insurance agent you work with or give us […]

Health Insurance Terms | In-network

By on March 30 2012 | | Leave a comment

The term  “in-network” – describes a provider or health care facility which is part of a health plan’s network. When applicable, insured individuals usually pay less when using an in-network provider.  This means when going to a Doctor, a Clinic or hospital and you have health insurance (an individual or group plan) it is better […]

ACOs or Accountable Care Organizations

By on January 27 2012 | | Leave a comment

ACOs  (Accountable Care Organizations) are a part of the Health Care Reform Act (HCR) or its official name:  Patient Protection and Affordable Care Act (PPACA). This is scheduled to go into effect on January 1 2012 and, for the most part will impact Medicare .  ACOs  from what I can see look like  HMOs but will […]

Brand-name Drugs Defined

By on November 30 2011 | | Leave a comment

A brand-name drug – prescription drug which is marketed with a specific brand name by the company that manufactures it.  So brand-name drugs may cost insured individuals a higher co-pay than generic drugs on some health plans. The recent big news on brand-named drugs vs. generic’s is the story on Lipitor. Lipitor, which became available […]

Embedded Versus Aggregate Insurance Deductibles

By on October 7 2011 | | Leave a comment

The term embedded deductible means separate individual deductible. In most PPO health plans you have, say a $1,000.00 deductible plan and it has a $3000.00 family deductible. If a policy insures, say three people ( a father, mother and daughter) and two of them have medical procedures in the same year, then each must first […]

Health Insurance Aggregate Deductible

By on October 3 2011 | | Leave a comment

An important distinction needs to be made concerning how deductibles are computed for Qualified High-Deductible Health Plans.  The family deductible is an aggregate or combined deductible.  Each person’s covered medical expenses go toward meeting the family deductible.  Each insured person’s covered medical expenses go toward meeting this amount.  Once the family deductible is met, most […]

Health Insurance Deductibles

By on September 22 2011 | | Leave a comment

The deductible in a health Insurance policy is a defined dollar amount during the benefit period – usually a year – that the insured person pays before the insurance company starts to make payments for covered medical services. Plans may have both per individual and family deductibles. Some plans may have separate deductibles for specific […]

Insurance Actuary Defined

By on July 29 2011 | Glossaries | Leave a comment

An actuary is a mathematician in the insurance field. They are responsible for calculating premiums, developing plans and defining underwriting risk. A person who is an actuary by training or collage degree can work as an insurance company “underwriter”. This is the person that evaluates the risk in taking on a new policy for the […]

BMI & Personal Weight

By on July 28 2011 | | Leave a comment

What is BMI (Body Mass Index)? How is it calculated and what use is it to me and Insurance companies? BMI is a number based on a person’s weight and height that provides a way to estimate the effect of weight on health. The higher the BMI, the greater the risk of diseases such as […]

Agent – Broker | Glossary of Insurance Terms

By on July 19 2011 | | Leave a comment

I am picking up on my Glossary of term topic and am going to the beginning of the alphabet for this. I will talk of the title of Insurance Agent and Broker. An agent – a licensed individual who represents several insurance companies and sells their products. There are also agents that sell for and […]

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