Unless you work in the healthcare or insurance industry, understanding all the different terminology associated with a health insurance plan can go from confusing to overwhelming. What’s the difference between Medicare and Medicare Supplement? Are deductibles the same thing as copayments? What does PPO stand for? Below is a quick breakdown of common health insurance terms that you need to know.

Medicare

According to U.S. Department of Health & Human Services, Medicare is a health insurance program offered by the federal government that provides a set service coverage for people over 65 or with a severe disability, regardless of income. Medicare covers different services and is primarily broken up into two parts. “Part A” focuses more on hospital visits, hospice care, care in a skilled nursing facility, and some home health care. “Part B” covers certain doctors’ services, medical supplies, outpatient care, and preventative services.

Medicare Supplement

If you’re eligible for Medicare, that doesn’t guarantee that you’ll have access to both Part A and Part B coverage. If you find that you’re only covered by one of the two parts, Medicare Supplement plans offers the coverage you may otherwise be lacking. These plans can help with unexpected costs or copayments that otherwise would be incredibly expensive.

Deductibles & Copayments

A deductible is “the amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.” Some plans offer copayments, or "co-pay", which allows you to pay a set amount (or a set percentage in the case of coinsurance) instead of the full cost of a service or prescription, and your insurance provider pays the rest.
Premium
The total amount that you pay for your insurance per month is known as your Premium. This is the total after it has been adjusted based on plans, financial support, taxes, etc.

PPO

Finally, let’s talk about PPO, or “Preferred Provider Organization.” These are Insurance plans that offer coverage with a specific healthcare provider network. That means a PPO plan will only provide insurance when you visit clinics and hospitals under the same provider (such as Blue Cross Blue Shield). PPO plan allows for flexibility, as you are not required to have a primary care doctor and offers significant savings on your monthly premium!

Don’t let discussing health insurance feel like you’re speaking a foreign language. Tom Miroballi, Sales Inc will help you understand the different plans so you can choose the right coverage for the right price. Call Tom Miroballi, Sales Inc today at 630-863-3477 or click here to learn more about our services.