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Health Insurance Terms 101

September 2021

Health Insurance Terms 101

Health insurance has its own language. Many terms can be unfamiliar and some are downright confusing. So, how can you be expected to navigate your health coverage without understanding all the lingo? 

We can help shed some light on the topic. After all, the more you understand the nomenclature, the better equipped you’ll be to make the best healthcare decisions. 

Here are a few of the terms you’ll come across most often – as well as what they mean. 

Coinsurance: The percentage of an allowable charge you must pay for a covered service. Generally, your deductible must be met before your coinsurance applies.

Copayment (Copay): If your plan has copayments, they are the amount you pay each time a certain covered service is received.

Covered Services: Healthcare services, supplies, equipment, and care listed in a member’s certificate or contract, with the exceptions of excluded conditions and limitations that are also identified in the certificate or contract.

Deductible: This is the amount that must be incurred by each member of the policy before benefits become payable by Blue KC.

Explanation of Benefits (EOB): A statement sent listing healthcare service(s) obtained, amount(s) paid by the plan, and the total amount that a member may owe to a provider.

Service Area: This is the geographic area served by Blue KC, which includes 32 counties in the greater Kansas City area and northwestern Missouri.

Consult your handy Blue KC Glossary 

Any time you come across an unfamiliar term, look it up. Visit the Blue KC Glossary for more definitions, as well as our Frequently Asked Questions page for answers to things we get asked about most.

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