Understanding Health Insurance Lingo

Senior man looking up health insurance in Shingletown, CA

Health Insurance lingo can be confusing. 

As a result, understanding your benefits and what you may owe out of pocket can be difficult.  In order to make sure you are using your coverage effectively, it is important to understand some key health insurance terms. To better understand your health insurance, be aware of these terms:

  • A participant is the "provider” of service such as your primary care provider, x-ray, lab or hospital.

  • A premium is the amount of money charged by an insurance company for your coverage.

  • A deductible is the amount you owe for your health care services each year before your insurance company will begin to pay.

  • A copayment is the fixed amount you pay for a covered health service (for example a regular office visit).

  • Coinsurance is a percentage of the bill that you owe. For example you pay 20% and your insurance pays 80%.

  • Out-of-pocket maximum is the most you should have to pay for your health care during any year. After you pay that amount your insurance will pay 100% of the allowed charges.

  • An EOB (explanation of benefits) is something your insurance company will send to you to explain how much they paid and how much you may owe for a visit to a provider.

To help you with your Chiropractic care Shingletown Medical Center is happy to announce you can see our Chiropractor, Dr. Leach for a $35.00 fee if your insurance does not cover Chiropractic.

The staff at Shingletown Medical Center is proud to provide first-class care for you and your family.   

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