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Your place of work switched health insurance providers, so you now have a new policy but you have no idea what it covers. First, you should take a few minutes to read the rules. Don't be surprised if each word makes you even more confused. Many people walk at this pace, so you shouldn't be put off by it. If you know how they talk, insurance policies are easy to understand. You will definitely get lost if you don't speak their language, which most of us don't.
The first thing you need to know about your policy is what all of the terms mean. A deductible is a common term that you will see. A deductible is an amount you have to pay before you can use any of your health insurance benefits. Most of the time, this is an annual amount that varies a lot from policy to policy. Most of the time, an individual account and a family account have different deductibles. Some policies let people use some services before the deductible is met. After you've used up your deductible, you'll have to start over the following year.
Co-payments are dollar amounts that the customer has to pay before their insurance will pay for services. This is on top of the deductible that the customer has to pay. Some policies let the customer pay a co-payment instead of the deductible for certain services.
Out-of-pocket costs are those that the consumer has to pay for themselves. This could include things like deductibles and co-pays. The term "annual out-of-pocket expense" refers to the most a person would have to pay for health care that year, minus the cost of their premiums.
Most policies cover you for your whole life. This means that there is a limit on every policy. During the life of the policy, the policyholder's expenses can't go over a certain amount, or the insurance company won't pay. Don't be afraid. It is usually a very high amount at first, but with the way health care costs are going up so quickly, a person can reach it quickly.
The exclusions section must also be carefully read, and a person buying health insurance must fully understand the policy. Exclusions are situations that aren't covered by the policy. This area can be very cloudy. The policy may cover the surgery but not the care that comes after it, or it may cover the care that comes after the surgery but not the surgery itself. This part of your policy is the most important, so read it carefully to make sure you understand all of the exclusions.
As you read your health insurance policy, there are many things you should always keep in mind. Read every paragraph of the policy to make sure you understand how it works and won't have any questions if you ever need to use it.
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