A health insurance plan is what allows an insurance provider to cover your health needs and determines how much you'll pay out of pocket. While each plan offers different coverage levels, all plans offer a list of 10 essential health benefits under the Affordable Care Act (ACA).
In fact, enrolling in health insurance has become mandatory to most Americans under the Affordable Care Act, who may risk paying a tax penalty if they do not enroll in a plan.
While the idea of health insurance is simple, the details become complex once you start shopping for a plan.
Let us delve into some basics. That way, you can ask some specific questions when you speak with one of our licensed agents.
What is Health Insurance: 7 Definitions You’ll Need to Know
- Premium: This is your monthly, quarterly, or semi-annual payment to a health insurance company, securing your coverage.
- Deductible: What you must spend out-of-pocket for medical services before your insurance company begins to pay.
- Public insurance: This is government-provided health insurance, including Medicare and Medicaid in the United States (these programs cover more than 100 million people).
- Private insurance: This is coverage offered through a private insurance company. Roughly 6 million Americans carry private insurance, which is often provided by employers.
- Health insurance exchanges: These are marketplaces, run by state governments and the federal government, that allow you to compare insurance plans. Eligible adults can reduce premium costs through subsidies.
- Copayment: A fee your insurance company requires you to pay for a certain medical service or supply.
- Coinsurance: The percent amount you may be required to pay for covered medical services after you have satisfied your plan deductible.
If you’re still not sure what health insurance is, this short list of definitions could feel like a dictionary. Fortunately, there’s help. Free help. HealthMarkets Insurance Agency offers support online, in person, and by phone for individuals and families who are looking for health insurance. The Better Business Bureau even gives us an “A+” rating!