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Insurance terms

Steve Kibbe, owner of Kibbe Insurance

Insurance terms can be confusing. It can seem like a foreign language. We've been doing this a long time and speak this language!

Let's start with the basics:

What is a premium?

The dollar amount you pay for a insurance policy.

What is a deductible?

The dollar amount you have to pay before the insurance company pays for a covered service. Some services do not have a deductible.

What is coinsurance?

When you pay a percentage of a service and the insurance company pays a portion.

What is max out-of-pocket?

The total dollar amount you responsible to pay, usually includes deductibles, coinsurance and copays.

What is a co-pay?

The dollar amount you have to pay for a doctors visit, prescription, or service.

What is a network?

A list of doctors, hospitals, and pharmacies contracted to provide care and services.

What is a PPO, Preferred Provider Organization?

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.

What is a HMO, Health Maintenance Organization?

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

What is a EPO, Exclusive Provider Organization?

A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan's network (except in an emergency).

Have more questions? We can help. Our contact info is at the bottom of this page.

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