Deductible – A specified amount of money that the insured must pay before the insurance company will pay a claim.
Health Savings Account (HSA) – These accounts are for high-deductible health plans. Money can be deposited without paying federal tax at the time of deposit. The funds can be used for qualified medical expenses. HSA funds can be rolled over from year to year.
Flexible Spending Account (FSA) – A financial account that can be set up through a cafeteria plan of an employer in the US. An FSA allows an employee to set aside a portion of earnings to pay for qualified expenses like medical expenses but often for dependent care or other expenses. Money deducted from an employee’s pay into an FSA is not subject to payroll taxes, resulting in payroll tax savings
Health Network – In-network providers are doctors, specialists, surgeons, labs, hospitals, pharmacies and radiology facilities who join the insurance network. These providers will abide to pay a contracted amount for services. Out-of-Network providers are the same type of medical providers who have not contracted for an agreed upon set rate and therefore services will be higher based on the providers own discretion.
HMO – Health Maintenance Organization is a medical insurance group that provides health services for a fixed annual fee.
PPO – Preferred Provider Organization is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the insurer’s or administrator’s clients.
Copay – A copayment or copay is a fixed amount for a covered service, paid by a patient to the insurance company before patient receives service from physician.
Coinsurance – coinsurance is a percentage that the insurer pays after the insurance policy’s deductible is exceeded, up to the policy’s stop loss.