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Terminology
High Deductible Health Plans and Others
Networks
Benefits
100

It houses ex-ray and a stitch cart but there's no overnight stay here.

What is an urgent care center?

100

What is term for the negotiated amount that is payable under the health insurance plan for a specific service or proceedure?

What is the Allowable Charge?

100

What is the name of the Blue KC high deductible health plan?

What is BlueSaver?

100

What is the name of BlueKC's HMO network?

What is Blue Care?

100

This is an amount you pay for major medical services before BlueKC begins to pay

What is a deductible?

200

Go here if your life or limb are threatened.

What is the emergency room?

200

What is it called when a provider sends an invoice to a member for charges that exceed that allowable charge?

Who is Balance Billing?

200

What are the three ways you can save taxes by using a Health Savings Plan?

1) The money goes into your account tax free 2) grows tax free an as long as you spend it on eligible expenses 3) comes out tax free.

200
The number of counties that make up Blue KC's service area?

What is 32?

200

This type of plan has no medical or RX copays and allows you to open a Health Savings Account.

What is a Qualified High Deductible Health Plan?

300

It can treat your strep throat, sprained ankle and schedule your next appointment.

What is your doctor office?

300

What is the type of deductible if a member is covering a family or more than one person, the entire Family deductible must be met before the plan begins to pay for those services.

What is an Aggregate Deductible?

300

A Health savings Account is not a 'use it or lose it' account, what is the name of the type of account that requires you to spend the money by the end of the year?

What is a Flexible Spending Account?

300

What are the two hospital systems locally that make up the Blue High Performance Network?

What are St. Luke's Health System and CHildren 's Mercy?

300

These are the shared expenses between you and BlueKC after you have satisfied your deductible.

What is coinsurance?

400

If your doctor can't see you or the office is closed, this option allows you to walk into a clinic for non- life threatening illnesses. 

What is urgent care or retail health clinic?

400

What is the type of deductible where no one individual in the family pays more than the individual deductible?

What is an Embedded Deductible?

400

What is the type of account that is funded by an EMPLOYER?

What is a Personal Care Account?

400

What is the name of the HMO program that gives members convenient healthcare coverage while away from the Home HMO?

What is Away From Home Care?

400
What doesn't count toward your Deductible?

What is Sopays and Coinsurance?

500

What is the acronym for a Family medicine practitioner who focuses on your overall health and wellbeing?

What is a PCP?

500

What is the term that establishes the order of payment when two or more medical plans (primary and secondary)?

What is Coordination of Benefits?

500

Five examples of types of services that allow you to spend the money from a Health Savings Account?

What is dental, vision, medical, prescription, lasik, hearing aids, etc....

500

Between a PPO and an EPO, which plan type requires you to seek services from an in-network provider except for emergencies?

What is an EPO plan?

500

This is your deductible, plus coinsurance, plus medical and RX copays.

What is your Out of Pocket Maximum

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