Glossary & Definitions

There is a wide variety of definitions that you should be familiar with in order to better understand your low cost health insurance policy. This glossary is complete with definitions that will enable you to familiarize yourself with important terms associated with low cost health insurance plans.

Copay - A fee the policyholder pays for an office visit, specific treatment or prescription.

Deductible - The amount you pay before your insurance starts paying.

Exclusions/Limits - These are the medical treatments your healthcare provider either doesn't cover or only partially covers. Also, some policies limit their payout to a yearly or lifetime sum.

Premium - The cost, per pay period, of an insurance plan.

Quote - A price offered by an insurance agent for a policy.

Health discount plan – Health discount plans provide fee-paying members with access to a network of professionals that charge reduced rates.

Note: Health discount plans aren’t insurance policies and therefore aren’t regulated in the states in which they’re sold. As a result, quality and reliability can vary widely. The National Association of Insurance Commissioners urges caution when buying a discount plan. Learn more here.

HMO - (Health Maintenance Organization) An HMO is a comprehensive managed care plan that pays only for in-network care.

HSA - (Health Savings Account) HSAs are interest-earning, tax-advantaged savings accounts that are used to cover medical expenses. HSAs are often paired with a trimmed-down, high deductible managed care policy, such as a PPO.

Indemnity plan - Indemnity policyholders pay for their medical care as they go and are reimbursed by their healthcare provider either in full or partially. Also known as fee-for-service plans.

Managed care plan - Managed care plans offer comprehensive care in exchange for a regular premium. According to the Insurance Information Institute, about half of Americans are enrolled in some kind of managed care plan.

POS - (Point of Service) A POS is a managed care policy that gives members the option to choose between in-network and out-of-network care.

PPO - (Preferred Provider Organization) A PPO is a managed care policy that gives members access to a network of providers who charge reduced rates. Members pay for care as it’s needed.

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