Common Healthcare Definitions

Deductible - The amount of money that you will pay out of pocket for medical expenses before the insurance company will begin covering their share. The deductible applies to certain procedures like diagnostic tests and imaging. Copayment - A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. Coinsurance - The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible. EOB - An EOB is a statement from your health insurance plan describing what costs it will cover for medical care or products you’ve received. The EOB is generated when your provider submits a claim for the services you received. In Network - In network refers to providers or health care facilities that are part of a health plan's network of providers with which it has negotiated a discount. Out-of-Network - This means that a doctor or physician does not have a contract with your health insurance plan provider. This can sometimes result in higher prices. PCP - This stands for Primary Care Physician, and this is the doctor that you choose to see for your annual physical and office visits. If you're on an HMO plan, this doctor will provide referrals to specialists when needed. Specialist - These are doctors who practice a specific type of medicine, like a dermatologist, chiropractor, or a cardiologist, for example. COMMON HEALTHCARE TERMS