Don’t understand some of those tricky words and terms your health insurance company uses? Here are some quick definitions and explanations to help you better understand your health insurance and get the most out of your plan.
Benefit: A term referring to any service (office visit, laboratory test, surgical procedure, etc.) or supply (prescription drugs, medical equipment, etc.) covered by your health insurance plan throughout the normal course of a patients’ healthcare.
- Benefits of a health insurance plan can include primary care physician office visits, ER visits, lab tests, your prescription drugs, along with other terms and services specified in your plan.
Brand-Name Drug: A prescription drug that is manufactured and sold by the pharmaceutical company that originally researched and developed the drug.
- Brand name drugs have the same active-ingredient formula as the generic version of the drug, however, generic drugs are manufactured and sold by other drug manufacturers and are generally not available until after the patent on the brand name drug has expired.
Balance Billing: A request for payment by a provider (doctor) to a member for the difference between your insurance plan’s allowed amount and the billed charges for using an out-of-network provider.
- Balance billing is not allowed by plan providers because they are inside your insurance company’s provider network.
Definitions found at eHealth. For more health insurance definitions please visit eHealth Health Insurance Glossary.
Published February 13, 2018
