Navigating the Health Insurance Landscape by Robert Adziashvili - HTML preview

Navigating the Health Insurance Landscape

Cl ai m: A request fo r paymen t t hat yo u o r yo ur heal t h c are pro v i der submi t s t o yo ur heal t h i n surer when yo u get i t ems o r serv i c es yo u t hi n k are c o v ered.

CO BRA ( Co n so l i dat ed O mn i bus Budget Rec o n c i l i at i o n Ac t ) : A federal l aw t hat may al l o w yo u t o t empo rari l y k eep heal t h c o v erage aft er yo ur empl o ymen t en ds, yo u l o se c o v erage as a depen den t o f t he c o v ered empl o yee, o r an o t her qual i fyi n g ev en t .

Co i n suran c e: Yo ur share o f t he c o st s o f a c o v ered heal t h c are serv i c e, c al c ul at ed as a perc en t ( fo r exampl e, 2 0 % ) o f t he al l o wed amo un t fo r t he serv i c e.

Co mmun i t y Rat i n g: A rul e t hat prev en t s heal t h i n surers fro m v aryi n g premi ums wi t hi n a geo graphi c area based o n age, gen der, heal t h st at us o r o t her fac t o rs.

Co n sumer Assi st an c e Pro gram: Pro grams t hat hel p yo u fi n d heal t h i n suran c e, appeal den i al s o f c are, o r fi l e c o mpl ai n t s an d mo re.

Co n t i n gen t E n ro l l men t : E n ro l l men t i n a heal t h pl an t hat 's depen den t o n passi n g a medi c al exami n at i o n o r gi v i n g a det ai l ed heal t h hi st o ry.

Co paymen t ( o r Co pay) : A fi xed amo un t yo u pay fo r a c o v ered heal t h c are serv i c e aft er yo u'v e pai d yo ur deduc t i bl e.

Co st -S hari n g: The share o f c o st s c o v ered by yo ur i n suran c e t hat yo u pay o ut o f yo ur o wn po c k et .