Health insurance in America (aka 美国医保) is one of the most important investments we ever make. Illnesses, injuries, and other medical setbacks can be astronomically expensive if hospital visits, surgery, or other serious measures are required; maintaining health coverage is the wise way to ensure we aren’t stuck covering these emergency medical costs out-of-pocket. Hence, recommended OPT health insurance (aka opt保险推荐) and/or recommended H-1B health insurance (aka h1b保险推荐) are popular among international students who work in the U.S. after graduation, since they are cheaper than the marketplace health insurance plans.
In order to obtain the proper level of coverage, one must understand basic jargons in either F-1 health insurance (aka f1 保险) or American college insurance (aka 美国大学保险) and OPT health insurance (aka opt保险). Let’s begin with a few key definitions. Understanding important terminology pertaining to health insurance is the first step to obtaining a cost-effective coverage plan that serves all of your individual or family needs.
Premium: The amount you pay your insurance company for health coverage each month or year.
Deductible: The amount of money you must pay out-of-pocket before coverage kicks in. Deductibles are usually set at rounded amounts (such as $500 or $1,000). Typically, the lower the premium, the higher the deductible.
Coinsurance: The amount of money you owe to a medical provider once the deductible has been paid. Coinsurance is usually a predetermined percentage of the total bill. If the policy’s co-insurance is set at 15% and the bill comes to $100, the policy-holder owes $15 in co-insurance.
Co-pay: This type of insurance plan is similar to co-insurance, but with one key exception: rather than waiting until the deductible has been paid out, you must make their copayment at the time of service. Most often, copayments are standardized by your plan, meaning you’ll pay the same $30 each time you see a physician, or the same $50 each time you see a specialist.
Out-of-pocket maximum: The amount of money you pay for deductibles and coinsurance charges within a given year before the insurance company starts paying for all covered expenses.
In-network: This term refers to physicians and medical establishments that deliver patient services covered under the insurance plan. In-network providers are generally the cheapest option for policyholders. Insurance companies typically have negotiated lower rates with in-network providers.
Out-of-network: This term refers to physicians and medical establishments not covered under your insurance plan. Services from out-of-network providers are usually more expensive than those rendered by in-network providers. This is because out-of-network providers have not negotiated lower rates with your insurer.
Pre-existing condition: Any chronic disease, disability, or other condition you have at the time of application. In some cases, symptoms or ongoing treatments related to pre-existing conditions cause premiums to be higher than usual.
Waiting period: Many employer-sponsored insurance plans mandate a period of 90 days before employees can enroll in their insurance plans.