Health Care Collaboration

If you are looking to buy individual or family health insurance, it may be beneficial to rely on the support of a health insurance agent or broker. You may have had health insurance through your previous employer, in which you had only a few minor choices to make and the cost may have been significantly less. Now you found yourself going at it on your own and you may be doing your own research on the internet. This can be frustrating. You may want to get some help from a professional.

If you search for a health insurance policy online, you may have several different agents contact you. This may be slightly annoying, however it provides you with the opportunity to shop for the best policy and get different agent’s perspectives on different types of insurance plans. The health insurance agent or health insurance agent or broker’s responsibility is to help you determine your needs, explain the best plans to fit your needs, and help you choose the plan. It is important that your health insurance agent obtains the most accurate health insurance information in order to be able to qualify you for health insurance. The agent’s responsibility is to find you the most affordable policy that meets your needs. The agent is under constantly being monitored for the appropriateness of the policies that he or she sells.

While “interviewing” health insurance agents, you will want to check with your State Department of Insurance to make sure the prospective agent is licensed to sell health insurance in your state. It is also important to find out if the agent is in good standing with your state’s Insurance Department. Another good idea is to ask the agent for client testimonials or references. You should have a general understanding of health insurance terms. You can gain a further understanding of these terms when you begin working with your agent.

It is important to have a general understanding of some health insurance terms. If you are unsure of certain terms, ask your agent to clarify by providing written examples or case studies. The definitions provided below may be a helpful start to developing health insurance terminology

Deductible

How much you pay toward a covered expense before the plan pays a benefit.

Office Copay

Office Copay is a benefit that allows you to pay only a flat dollar amount for eligible in-network physician office visit services. This option may not always be available.

Coinsurance Percentage

Coinsurance percentage refers to the amount of covered expenses you pay after the deductible. You usually share the cost of covered expenses with the insurer. For example, a coinsurance percentage of 70% means that, after the deductible, the insurer pays 70% of covered expenses and you pay 30%.

Coinsurance Out-of-Pocket

Coinsurance is the percentage of covered expenses the plan pays after you meet the deductible. After the Out-of-Pocket maximum is met, the plan pays 100% of covered expenses.

Lifetime Maximum

The amount of the total lifetime benefit of the policy per person covered by the policy.

Annual Maximum

How much that is paid per person and covered on the policy during the calendar year after the insured has satisfied all out-of-pocket expenses. This option may not be available with all plan types.

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