Coinsurance
The amount you are required to pay after you have met your deductible. For example, if the health insurance company pays 80 percent of the claim, you pay 20 percent.
Co-payment
You pay a flat fee every time you receive a medical service (for example, $15 for every visit to the doctor). The health insurance company pays the balance.
Deductible
The amount of money you must pay each year to cover your medical care expenses before your health insurance policy starts paying.
Managed Care
A method of providing quality health care by managing a patients activity and cost. All HMOs and PPOs, and many fee-for-service plans, have managed care plans.
HMO Plan (Health Maintenance Organization)
HMOs are prepaid plans. Your care is managed by your primary care physician. You pay a monthly premium and the HMO covers your services covered under the umbrella of the organization. You must use the doctors and hospitals designated by the HMO.
Primary Care Doctor (PCP)
Chosen from a list provided by your coverage provider, a primary care (referred to as the gatekeeper)doctor monitors your health treats health problems, and refers you to specialists if necessary.
PPO (Preferred Provider Organization)
A combination of traditional fee-for-service and an HMO. Greater coverage of your services is obtained by use of the doctors and hospitals that are part of the PPO. You can use other doctors, but at a higher cost.
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