Basic Terms
The amount you pay every month for insurance
Premium
You visit a doctor and pay $25 at the front desk
Copay
Premium = $200/month. Yearly cost?
$2,400
Plan type that usually requires referrals
HMO
You always want the cheapest premium
False
What you pay before insurance starts covering costs
Deductible
You haven’t met your deductible and get a $500 bill—you pay it all
Deductible applies
Deductible = $1,000. You’ve paid $600. How much left?
$400
Plan type that gives more flexibility but costs more
PPO
Insurance covers everything immediately
False
A fixed amount you pay for a doctor visit
Copay
You go to a doctor not covered by your plan
You go to a doctor not covered by your plan
Copay = $30. You go 4 times. Total?
$120
Plan with lower premiums but higher deductibles
High-deductible health plan
A higher deductible usually means lower monthly cost
True
The most you’ll pay in a year before insurance covers 100%
Out-of-pocket maximum
You’ve hit your out-of-pocket max and go to the ER
Insurance pays 100%
Out-of-pocket max = $5,000. You’ve paid $5,000. Next visit cost?
$0
Government insurance for people 65+
Medicare
Out-of-network care is usually more expensive
True
Doctors and hospitals that accept your insurance plan
Network
You choose a cheaper monthly plan but pay more when you get care
High deductible plan
Premium $100/month vs $300/month—difference yearly?
$2,400
Government program for low-income individuals
Medicaid
Young, healthy people don’t need insurance
False