Health Literacy Insurance Terminology

What are medical expenses NOT refunded by insurance?

• Allowed Amount

• Insurance Cap

• Prescriptions

• Out-of-pocket Expenses

A coinsurance is?

• A percentage to pay of the total cost of medical services.

• Amount insurance company match as payment for services.

• Up to 25% more than a patient's flexible spending account.

• Amount patient pays before plan begins to pay.

An out-of-pocket maximum is:

• Same as deductible

• The most an insurance will pay

• The maximum a patient pays for covered services each year

• Maximum charges a doctor can assess

The fee paid monthly to receive health insurance is the deductible.

• True

• False

What is a Copayment (or “Copay”)?

• A fix amount paid for medical care after your deductible has been paid

• Percentage of medical bill patient pays along with insurance

• Set amount patient must pay toward your medical bill every year

• A payment required for active coverage.

What is a deductible?

• Amount paid in order to receive work insurance

• Amount paid before the insurance company pays for coverage

• Amount paid to decrease insurance company coverage

• Amount paid as beneficiary payment

The out-of-pocket max is a cap or limit on the amount of money you have to pay for covered services in one year.

• True

• False

The most a plan will pay for a covered health care service.

• Premium

• Coinsurance

• Deductible

• Allowed Amount