Individual Health Insurance
You will find plenty of websites and toll-free phone numbers that will tell you what individual health insurance costs. Not only will we tell you what the right plan costs, more importantly, we will tell you what it is and how it works.
Individual Health Plans Terms/Definitions
Deductible
A specified amount of money that the insured must pay before an insurance company will pay a claim.
Coinsurance
The percentage of an insurance claim that is the responsibility of the insured, once the deductible is met.
Co-pay/Co-payment
Drug Formulary
A list of drugs covered by a health insurance plan.
Preventive care
In-network provider
Doctors and other health care providers that have agreed to accept a contracted rate as payment in full for services billed to your insurance company.
Out-of-network provider
Doctors and other health care providers that HAVE NOT agreed to accept a contracted rate as payment in full for services billed to your insurance company.
HMO
Health maintenance organization, a health insurance structure that manages patient care by coordinating the relationship between patient, health care provider and insurance company.
PPO
Preferred provider organization, coverage is provided to policyholders through a network of clinics and hospitals. Policyholders may obtain care outside the network but will pay higher out-of-pocket costs.
HRA
Health reimbursement account, employer funded account used to reimburse employees for qualifying medical expenses.
HSA
Health savings account, tax favored, individually owned savings accounts available to US taxpayers enrolled in high-deductible health plans (HDHPs). HSA deposits may be used to pay for qualifying medical expenses.
PPACA (Health Care Reform/Obamacare)
Patient Protection Affordable Care Act, the sweeping healthcare bill signed into law by President Barack Obama on March 23, 2010.
Exchange/Marketplace
A major element of Obamacare. These federal and state websites and call centers are utilized to determine federal tax credit eligibility. These tax credits are used to reduce health insurance plan premiums.