Erlanger Logo

Glossary of Terms

Common Terms:

Catastrophic coverage:
Health insurance with a low monthly premium and a very high deductible. It can protect you from paying for an unexpected catastrophic illness or event, and instead you’ll pay for the routine medical expenses.

A health insurance claim is a request to the insurance company asking for a payment based on the terms of the insurance policy.

A set price you pay when you receive care. Typical copays are for office visits, prescriptions, or hospitalizations.

After the deductible has been met, the coinsurance is a determined percentage of the cost of treatment the patient must pay for all covered medical expenses.

The amount of health care that the patient pays for before insurance will start paying for it. A high deductible plan typically means lower premium costs.

Disability income insurance:
This plan provides an income if the patient becomes unable to work due to an injury or illness. Benefits are typically around 60% of your income at the time of disability.

Health Savings Accounts:
A tax-deductible, tax-free interest account that an individual contributes to in order to pay for qualified healthcare expenses.

Doctors, health care professionals, clinics or hospitals that have a contract with your health insurance company to offer health care at set rates.

Long-term care policies:
These health insurance policies will cover most medical care if a patient is unable to care for themselves due to a long-term illness or disability.

A group of doctors, health care professionals, clinics and hospitals that have a contract with your health insurance company.

When a doctor, clinic or hospital and an insurance company don’t have a contract allowing in-network access and lower pricing for a particular health plan’s members.

Out-of-Pocket Costs:
Expenses for health care that your health insurance company doesn’t pay. You will have to pay for these costs on your own.

Pre-existing condition:
A health condition that a person has when they sign up for health insurance.

Premiums: Your monthly or quarterly payment for your health insurance.

Primary Care Physician (PCP):
A doctor who helps you manage and get health care services.

Provider: A doctor, health care professional, clinic or hospital that provides care to a patient. These professionals and facilities are usually licensed, certified or accredited by state law.