Deductible
This term refers to how much the user would need to give or pay to the health insurance company before he or she is able to use the benefits covered in the health insurance policy. Normally this amount is paid per year so after a year, the deductible would be present again and would need to be settled. Although some benefits such as visiting doctors could be used even without completing the payment for the deductible. There are types of deductible amount depending on your plan or status: the individual deductible amount and the total family deductible amount.
Out-of-Pocket
This simply refers to the amount you would have to pay out of your own pocket. This just pertains to how much the co-insurance or deductible is. As for the term “annual out-of-pocket maximum”, that just points to the total amount the user has to pay for their individual health insurance plan for a whole year out of their own pocket, not including the premiums.
Exclusions
The exclusions are the illnesses or situations that the individual health insurance plan will not pay for or cover.
Co-insurance/Co-payment
This term in any individual health insurance plan refers to the amount that the user needs to pay aside from the deductible before the health insurance company pays. Just like the deductible, some insurance companies allow users to avail of certain services even if the co-insurance has not been fully met yet.
Lifetime Maximum
The term 'lifetime maximum' just refers to the largest amount the health insurance company is willing to pay for the entire life of the insurance. Take note that the individual lifetime maximum and the family lifetime maximum are two different amounts.
Pre-existing Conditions
This term refers to a disease or sickness that the user obtained before availing of the individual health insurance plan. There are plans that cover pre-existing conditions while other health insurance companies place them under the list of exclusions.
Now that you have learned most of the terms in your individual health insurance plan, you will be able to decide which plan to choose and at the same time know how to use the individual health insurance plan the right way.
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