Insurance Terms Glossary

Understanding your healthcare coverage starts with knowing the terminology

Most Common Terms

Essential insurance terms everyone should know

Deductible

The amount you pay for covered health care services before your insurance plan starts to pay.

Example: If your deductible is $2,000, you'll pay the first $2,000 of covered services yourself.

Copayment

A fixed amount you pay for a covered health care service after you've paid your deductible.

Example: $25 for each doctor visit

Coinsurance

Your share of the costs of a covered health care service, calculated as a percentage.

Example: 20% of the allowed amount for a surgery

Letter A

Allowed Amount

Maximum amount on which payment is based for covered health care services.

billing

Ambulatory Care

Health care services provided on an outpatient basis.

medical

Letter B

Balance Billing

When a provider bills you for the difference between their charge and the allowed amount.

billing

Benefit Period

The length of time during which a benefit is paid.

insurance

Letter C

Claim

A request for payment that you or your health care provider submits to your health insurer.

billing

Coordination of Benefits

Process of determining which insurance plan pays first when you have more than one plan.

insurance

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