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Navigating the healthcare system can be complex and we are here to put the puzzle pieces together by providing educational resources.
Below are common health insurance terms. Please consult with your plan for specific plan benefits.
Through the Basic Health Program, states can provide coverage to individuals who are citizens or lawfully present non-citizens, who do not qualify for Medicaid, CHIP, or other minimum essential coverage and have income between 133 percent and 200 percent of the federal poverty level (FPL).
A percentage of costs that you pay for covered health care services usually after you’ve paid your deductible.
A fixed dollar amount that you pay for a covered health care service usually after you’ve paid your deductible.
The amount you pay for covered health care services before your insurance plan will pay for those services.
A list of prescription drugs covered by your plan’s prescription benefits.
Employer sponsored coverage is health insurance obtained through an employer and offered to employees and their dependents. It is also commonly called group coverage.
Individual health insurance policies are not connected to employer sponsored coverage. Such policies may be purchased directly from an insurance company or through a health insurance marketplace for you and your family.
Federal-state insurance program, and its guidelines vary from state to state. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses; however, a small copayment is sometimes required.
Federal health insurance program for: People who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
The maximum amount that you have to pay for covered services in the plan’s coverage year.
The amount you pay each month to have health insurance coverage.
The providers, facilities, and pharmacies that your plan has contracted with to provide health care services.
TRICARE is the health care program for uniformed service members, retirees, and their families around the world.
Select your state to learn more about your health insurance options.
State Based Exchange
Federally Based Exchange
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