The terms you'll find in your health insurance policy may sound like a foreign language. As with any industry they have their own lingo but it is very important you understand what it means. Below there are some explanations of a few of the major terms with which you must be familiar.
The deductible is the expense you will incur out of your own pocket before the company pays their percentages on procedures. These deductible amounts can vary widely and if you choose a high deductible plan your premium cost will be less expensive. This figure is very important to your coverage and expenses. Reviewing Co Pays in your policy is a must as this is the expense you will pay for each visit or procedure. This can be a percentage or dollar figure depending on the policy. As this money comes out of your pocket you want to know this section of your policy very well. While you're looking at this attempt to find if the co pays are different for different services, like $20 for doctor visit or $150 for emergency room.
Your Lifetime Coverage Amount refers to the maximum amount of monies which will be paid from the policy for your lifetime. Once this figure is reached there is no more payment. So even if you're healthy now you should pay close attention to this figure because a serious illness or injury could get you to that amount quickly.
Maximum Out Of Pocket - This amount, is the maximum amount that your insurance will require you to pay out of your pocket, and it is a good clause to have written into your policy, because this means that once you exceed that amount, you health insurance will cover you at 100%.
There will be Exclusions included in the policy, all of them have them, there are things insurance just won't cover. Most have them listed altogether but some may have them everywhere. Also doublecheck to see if there are referrals required or prequalification/precertification requirements. Choice of providers is crucial also, you need to see their list because going to their preferred providers will be the cheapest out of pocket.
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