Medical Insurance Terminology

What is the money you pay a company every month for medical coverage called?

• premium

• co-payment

• coinsurance

• out of pocket maximum

What do you call the amount of money you must spend before your insurance company will pay any expenses called?

• premium

• deductible

• co-payment

• coinsurance

What is paid by the patient every time they are seen for medical care in an office setting?

• premium

• deductible

• copayment

• coinsurance

What do you call it when your insurance company pays a percentage of the total medical costs?

• premium

• deductible

• copayment

• coinsurance

What do you call the most a patient ever has to pay themselves for a medical bill?

• out of pocket maximum

• premium

• coinsurance

• deductible

What do you call the list of physicians who are willing to accept your insurance as full payment for their bill?

• provider network

• coordination of benefits

• explanation of benefits

• remittance advice

What do you call it when a new insurance policy makes you wait for a preexisting condition to be covered under the new policy?

• exclusion

• beneficiary

• premium

• assignment of benefits

What do you call the name of the person covered under the terms of the policy?

• beneficiary

• subscriber

• provider

• patient

What do you call it when a second insurance pays for the remainder of a bill that the patient's primary insurance did not?

• coordination of benefits

• assignment of benefits

• explanation of benefits

• co-payment

What is used when a dependent child has parents with two different insurance policies?

• coinsurance

• coordination of benefits

• birthday rule

• out of pocket maximum