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Coming to Terms with Common Health Insurance Terms

January 2022

Coming to Terms with Common Health Insurance Terms

Health insurance has its own language. There are acronyms – that stand for what? There are dozens of unfamiliar terms. We know it can feel overwhelming. We also know that when you have a better handle on the terms, you are better equipped to make the right healthcare decisions for you and your family.  

Look it up in the Blue KC Glossary

Any time you come across an unfamiliar term, you don’t need to wonder what it means. We encourage you to look it up.  

You can visit the Blue KC Glossary for definitions, as well as our Frequently Asked Questions for topics ranging from billing to prescription drugs to provider selection.

Some common terms to get you started  

Here are a few of the terms you’ll come across most often.

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. 

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