Billing Policy | Insurance Terminology | Medicare DME Coverage
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Insurance Terminology:
We recognize that understanding your health insurance benefits can be confusing. To help you better understand the terminology used by insurance companies and medical providers, we've included information below on each of these commonly used terms.
Coinsurance:
Coinsurance is the percentage of the medical expense you are responsible for once you meet your deductible. For instance, under an 80/20 plan, the insurance company pays 80% and the patient pays 20% of the covered charges.
Copayment:
Copayment or copay is the dollar amount of the medical expense you are responsible for once you meet your deductible. For instance, you may have a copay of $15 for all physician office visits.
Deductible:
A deductible is the amount you must pay before your insurance starts to pay its portion of costs for a covered service. You are responsible for meeting your deductible each year. Once you have met your deductible, your insurance plan will begin covering a portion of your medical expenses. Depending on the terms of your plan, deductibles may not apply for every service. For example, you may not have a deductible for medical office visits, but you may be required to pay a deductible for Durable Medical Equipment.
Health Care Reinbursement Account (HRA):
A health reimbursement account (HRA) can be used to help pay for medical expenses you incur while you're covered under your employer's health insurance plan. With this type of account, your employer makes all contributions and maintains the account. When you have qualified medical expenses that haven't been paid by your health plan, you can pay for them with the money in your HRA.
Health Savings Account (HSA):
A health savings account (HSA) can be used to help you pay your deductibles, copayments, and coinsurance. You must be covered by a qualified high-deductible plan to be eligible to contribute to an HSA. If your employer offers an HSA as part of its benefits package, a certain amount is deducted from your paycheck each pay period and put into your account. When you have qualified medical expenses that haven't been paid by your health plan, you can pay for them with the money in your HSA.
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