When navigating the world of health insurance, you will likely encounter the term PPO (Preferred Provider Organization). A PPO plan – whether medical or dental – is about balancing the cost and convenience of care. With a PPO plan, you get the flexibility to see a wide range of doctors. You’ll save money by staying…
Ever found a confusing document in your mailbox after a doctor’s visit, wondering if it’s a bill, especially with an “amount you owe” at the bottom? You’re not alone! That document is most likely an Explanation of Benefits (EOB) from your health insurance company. It’s crucial to remember: an EOB is NOT a bill. Think…
Health care terms, medical bills, and forms can be hard to understand. Here are some common health care terms, and what they mean. Allowed Amount This is the maximum payment the plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.” For example, if you…
Selecting the right health insurance plans for your family is a critical process that requires careful attention from start to finish. Navigating health insurance becomes much simpler when you understand its terminology. Making sense of these terms empowers you to better understand your costs, benefits, and even estimate the price of a doctor’s visit. Premium:…
As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit…
Medical expense accounts can help you save on all kinds of healthcare costs. Here are some you may not know about yet. HSA, FSA, and HRA can typically be used for: Expenses that might be covered, but check your plan: Important Considerations: Additional Tips: By understanding the nuances of HSAs, FSAs, and HRAs, you can…
In today’s world of complex health insurance options, High Deductible Health Plans (HDHPs) have become increasingly popular. But with a name like “high deductible,” it’s natural to have questions. Let’s break down the basics of HDHPs: What is an HDHP? An HDHP is a health insurance plan with a higher deductible than traditional plans. This…
Insurance Costs Consumers typically pay the following types of costs when they have insurance. See Appendix A for examples of how cost sharing works. Tips to Know: Appendix A Examples of Health Insurance Cost Sharing This appendix provides some examples of how health insurance cost sharing works for consumers. These examples show different outcomes depending…
Does a Health Plan Typically Pay for Services from Any Doctor? Not always. Some types of plans encourage or require consumers to get care from a specific set of doctors, hospitals, pharmacies, and other medical service providers who have entered into contracts with the plan to provide items and services at a negotiated rate. The…
