Health insurance terms you should understand

It is not the easiest thing in the world to make sure you choose the right health insurance. You need to have someone to help you to understand all the terms that are used and how they affect your coverage. At Goshen Group Inc. in Glen Carbon, IL, we take the time to get to know our customers so that we can make the best recommendation for the coverage they need. 

Managed care

Managed care is the most common type of health care available. What it means is that someone will be managing your healthcare. Three main types of healthcare are offered: HMO, PPO, and POS.

HMO is the most restrictive type. You must have a primary care physician who manages your care. You must receive treatment within the network for the insurance to pay.

PPO will pay for healthcare outside the network and you don’t need a primary care physician. 

POS is a combination of HMO and PPO and does allow some payments outside of the network. 

Network

The network is the providers that the carrier has contracted with to provide services to their customers. Make sure your preferred providers are included.

Deductible

The deductible is the amount that you will need to pay out of pocket before your health insurance begins to pay. Higher deductibles are less expensive. 

Copays

Copays are the amount that is your share of all services that you receive. After you meet your deductible, a predetermined amount will be paid for certain services and you will pay the copay out of pocket. 

Formulary

The list of drugs covered by your insurance is presented in levels by cost to you. Copays and deductibles may apply.

Contact Us Today

Give Goshen Group Inc. in Glen Carbon, IL a call to make an appointment to review your medical coverage.