Glossary of Terms

Carrier/Insurer

These terms are interchangeable. Your insurance company is sometimes referred to as your carrier OR your insurer. Same deal. #111 11-8-17

COBRA

The Consolidated Omnibus Budget Reconciliation Act of 1985 (or COBRA) is a law passed by the U.S. Congress and signed by President Ronald Reagan that, among other things, mandates an insurance program which giv...

Coinsurance

Coinsurance is your share of the costs for a covered health care service, calculated as a percent of the allowed amount for the service, often for more significant services such as a hospital or out-patient pro...

Copay

A copay is the fixed amount you pay at the time of service for covered services, not typically subject to first meeting your deductible. Say for example, an office visit might cost you $25 or more depending on ...

Deductible

One of the first choices you’ll encounter in selecting health coverage is choosing a deductible amount. Usually, choosing a higher the deductible can lower your premium or other factors. A deductible is the amo...

Difference between HMO, PPO, EPO plans

In an HMO, you choose a family doctor, called a primary care physician (PCP), who provides the services you need. Your PCP refers you to other doctors or health care providers within the HMO network when you ne...

Essential Health Benefits

These benefits include the types of care you need to prevent and treat sickness. They do not include elective and “non-essential treatments.” Essential Health Benefits are minimum requirements for all individ...

Exclusive Provider Organization (EPO)

EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, however there are is NO coverage for out-of-network care. The network ...