No one wants to think about getting needing a doctor, but if you do, it can be incredibly costly without insurance. That’s why purchasing health insurance is one of the most important things you can do to protect yourself. It can mean the difference between a minor health care issue and a more serious one. But sometimes navigating the health care system can be confusing, especially when you get caught up in a lot of tricky insurance terminology.
At Value Plus Insurance, our insurance experts love helping Minnesotans access health care, and part of our job is to walk you through the process. In this post, we’ll cover some of the most common health insurance terms and how they affect you.
The term “copay” is short for “copayment.” A copay is the amount of money that an individual pays out-of-pocket at a doctor’s visit or when medical care is rendered. They’re usually paid at the beginning of an appointment, and a copay is almost always a fixed dollar amount. The amount of the copay varies according to your insurance plan.
An insurance deductible is an amount that a patient is required to pay out-of-pocket annually before their health insurance will begin paying for any medical expenses. After you’ve met your deductible, your insurance company and your copay combined will cover most of your medical expenses.
Most insurance policies offer a provider network they have contracted with. They’ll provide you with a list of medical providers who are in their provider network, and they will cover medical bills from those providers. If a provider is out-of-network, the insurance company may cover less of your medical expenses.
The term “out-of-pocket” refers to the amount that you pay and is not covered by your health insurance. Your deductible and copay are examples of out-of-pocket expenses. The amount you pay out-of-pocket will vary according to your insurance provider and plan.
5. Preferred Provider
A preferred provider is a participating physician or health care service provider that is within your network. Seeing a provider that is not preferred may not be entirely covered by your plan.
Preauthorization refers to approval of payment by your insurance company before services are delivered. For example, before you undergo surgery or begin a new treatment, your provider may submit the treatment for preauthorization to make sure it will be approved first.
Minnesota Health Insurance to Protect Your Family
Health insurance can seem confusing, but it doesn’t have to be. That’s why it’s important to have a great team in your corner to help you navigate the health care system and make the best decisions when choosing a policy.
At Value Plus Insurance, our personal insurance experts try to make the process as simple and clear as possible while pairing Minnesotans with the best plan for their unique needs. Speak with our insurance agents at 952-435-0550, or contact us to discuss the available options and learn more.