Insurance Vocab

3. A plan that allows you to see any doctor, but offers lower costs if you use in-network providers.
6. Health coverage issued to you directly (individual plan) or through an employer, union or other group sponsor (employer group plan) that provides coverage for certain health care costs.
8. A list of drugs your plan covers.
10. a common type of health insurance that requires you to get care from a certain network of providers. Covers out-of-network care only in emergencies or special circumstances
12. Your share of the costs of a covered health care service, calculated as a percentage (e.g., $20\%$) of the allowed amount, usually after you have met your deductible.
13. The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
14. A request to your insurance company to pay for services you received.
15. A doctor who manages your routine care and refers you to specialists.

1. A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.
2. A plan that usually limits coverage to care from doctors in the network and often requires a referral to see a specialist.
4. The annual amount you pay for covered health services before your insurance plan begins to pay.
5. a less common type of health insurance that partners with a group of clinics, hospitals and doctors to provide care. You’ll pay less out of pocket when you get care within that network
7. A written order from your primary care provider for you to see a specialist or get certain health care services.
9. The most you could pay during a coverage period (usually one year) for your share of the costs of covered services. After you meet this limit the plan will usually pay 100% of the allowed amount.
11. The amount of money a policyholder pays for insurance protection, i.e., the “cost” of the policy.