The 101 Cheat Sheet: What does that mean?

This “cheat sheet” briefly explains some terms that are used when discussing health care. Often times people are confused as to what kind of coverage they are recieving. But don’t worry, I also get confused when I go to the doctor and have to talk about my insurance. Hopefully, this will prepare us next time we go.

Co-pay: Also known as a co-payment, this is the amount of money (determined by your insurance company) that you pay each time you invest in a service within the health field.

Deductible: This is the amount of money that you will have to pay before your insurance company will pay for a claim cover the remaining costs.

Medicare: a federally administered health insurance plan that is available to people that are 65 years of age or older.

Medicaid: a healthcare program designed for families with low income.

Medicare Prescription Drug Plan: a new addition to Medicare, which provides partial payment coverage on generic prescriptions.

Assignment of Benefits: a form that you may sign that enables your medical provider to directly receive an insurance payment.

Benefit Penalty: In certain circumstances, an insurance company will reduce the payments on a claim when the agreements and rules of the insurance plan are not followed.

Health Insurance Portability and Accountability Act: Also known as HIPPA, this form is that piece of paper the front desk may make you sign. This form confirms your privacy by allowing you to control who has the ability to view and receive your medical records.

Out-of-Pocket Maximums: limits set by healthcare providers and limit the amount of money that a patient has to pay for a particular service during a designated period of time.

Private Pay: the use of personal monies to pay for healthcare services instead of using insurance coverage.

Ancillary Fee: a fee for prescription medications that are not listed under the list of covered medications by the insurance company.