Common Insurance Terms

1234567891011121314
Across
  1. 1. A plan that offers more flexibility in choosing providers and does not require referrals for specialists.
  2. 4. The amount you pay out-of-pocket for healthcare services before your insurance begins to pay.
  3. 5. A plan that combines features of HMO and PPO plans, allowing members to choose between in-network and out-of-network providers.
  4. 8. The amount paid for health insurance coverage; typically on a monthly basis.
  5. 9. A type of health insurance plan that requires members to use a network of providers and get referrals for specialists.
  6. 11. Providers and facilities that have a contract with the insurance company to provide services at negotiated rates.
  7. 14. Approval required before certain services or medications are covered; may also be called Prior Authorization (PA).
Down
  1. 2. Services like vaccinations and screenings that are covered without copayments or deductibles.
  2. 3. A plan that does not provide coverage until the deductible has been satisfied, with the exception of preventive care (i.e., annual age-based check-up)
  3. 6. The most you will have to pay for covered services in a plan year. After reaching this amount, the insurance pays 100%.
  4. 7. Providers and facilities that do not have a contract with the insurance company, often resulting in higher costs.
  5. 10. The percentage of costs of a covered healthcare service you pay after meeting your deductible.
  6. 12. A fixed dollar amount paid by the insured for a covered healthcare service, usually at the time of service.
  7. 13. Consolidated Omnibus Budget Reconciliation Act