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Glossary of Insurance Terms
| Annual maximum |
The amount of payments for medical services that an insurance
plan will make in a year. Any amounts incurred during the year above
the annual maximum are your responsibility. |
| Co-insurance |
A percentage of the cost of services that you have to pay, for
example, a plan may pay 80% of the charges and you pay 20%. |
| Co-pay |
The amount of money you need to pay for services, in addition
to the insurance payment. For example, most HMOs have a co-payment
of $10 for each doctor's office visit and $250 for each hospitalization. |
| Deductible |
The amount of money you have to pay before the insurance company
will pay for medical services. A deductible is usually annual, for
example you may have to pay $200 out of pocket each year before
your plan covers any medical care. A deductible may also apply to
a particular service, such as a $100 annual deductible for hospitalization. |
| Lifetime maximum |
The amount of total claims payments an insurance plan will make
for one patient the entire time they are covered by the plan. Any
amounts above the lifetime maximum are your responsibility. |
| Premium |
The rate you pay to be enrolled in the insurance plan. |
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