Annual Out-of-Pocket Maximum - This refers to the greatest possible amount you may have to pay for health care expenses during the calendar year. If/when you reach your Annual Out-of-Pocket Maximum, your plan will pay for 100% of approved, covered services.
Copay - This is is flat, standard fee that you’ll pay when visiting a doctor. You might have a copay of $10, for example.
HMO - With an HMO health plan, you’ll have to choose a family doctor, otherwise referred to as you Primary Care Physician (PCP). You’ll need a referral from your PCP to see a specialist within your HMO Network.
HSA - With an HSA health plan, you’ll keep a “savings account” specific for medical needs. The HSA plan often has high deductibles. This plan allows you to contribute to your medical savings account with pre-tax dollars, and you can use those tax-free funds to cover any approved costs.
Network - Your Network consists of doctors, labs, hospitals and other care providers who specifically work with an insurance company to provide services to members (including you, your spouse or your kids).
Out-of-Network - If service providers are outside of your Network, you’ll typically pay more money for services from those providers. In fact, HMO plans don’t cover services from Out-of-Network providers at all. Needing to visit the Emergency Room, even with an HMO, is covered as In-Network.
Obamacare - The official name is the “Patient Protection and Affordable Care Act”, (or you might know it as ACA) but you may know it as “Obamacare”. Our current health care law was signed as a bill by President Obama in 2010, though most of the law has only gone into effect starting in 2014.
PCP - Stands for “Primary Care Physician”, also referred to
as your family doctor. An HMO health care plan will require you to select a PCP. However, a PPO plan will not require you to choose a PCP.
PPO - This health plan allows you to visit health care service providers without needing referrals from your primary care physician. Your PCP is not in charge of which specialists you see, you choose from within your Network.