Health Insurance 101: The Terms You Need To Know

Everyone needs health insurance nowadays, but you may not know what you buy when you take out a new policy. Plus, you need to know what you have been offered when you get quotes from your employer.

An HMO is a health maintenance organization. You choose a family doctor that you go to for routine care. If you need to go to anyone else, that doctor will give you a referral.

Family Practitioner

You need a family doctor or Family Practitioner if you are in an HMO. The family doctor will give you referrals to specialists for more advanced care.


The network is the group of clinics, offices, and hospitals covered by the insurance plan. These offices and clinics need to choose to accept your insurance, and they will charge lower fees.

Out Of Network

You will pay more for care if you are out of your coverage network. Your explanation of benefits shows how much is covered when you are in and outside the network.

Your deductible is a yearly payment threshold that you must reach before the insurance plan pays for everything. It would help if you satisfied your deductible in a calendar year.



Your premium is the amount you pay every month for insurance. The premium changes are based on your deductible and the level of coverage that you want.

Annual Maximum Coverage

Allowed under your policy is the amount the insurance company will pay in one year for your care. You must pay for everything out of pocket if you go over that limit.

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