Insurance 101: Insurance A-Z

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Back in June Melissa and I wrote a blog post to help our readers become Insurance Savvy. One of our favorite features we found this last year to help explain the confusing world of insurance was the "No Excuses" Skimm'tionary guide by the Skimm. The site defines terms that are often thrown around during appointments, or calls to your insurance company. Not only is it informative...but funny! So what are some of the terms in the A-Z guide we found most helpful? See some of our favorites below!

Actuarial Value

The average percentage of your health care costs that the insurer covers. If a plan has an actuarial value of 70%, you’re on the hook for the other 30% of the cost of medical expenses. That’s where things like co-payments and your deductible come in.

Claim

A medical Venmo request. After you’ve visited the doc, you or your doc will send a claim to your insurance company for any services you received (think: lab tests, the visit itself). The insurance co processes it aka pays for its portion and then lets you know how much you might have to pay.

Copay

Like a cover charge without the open bar. It’s the flat fee you pay for covered medical services. Preventive care (think: annual physical) may be fully covered by your insurance, meaning no co-pay.

Out of Pocket Maximums

The max amount of money you have to pay for health care in a year. This includes money that goes towards your deductibles, copays, or coinsurance fees. After you meet your maximum, your insurance pays for all costs related to your covered health benefits. Win.

 

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Jody Vaynshtok

Jody is a California-licensed speech language pathologist with eight years of industry and clinical experience. She has worked with both adult and pediatric populations during her time at private practice, birth-to-three, and hospital facilities. She is experienced in the assessment and treatment of a variety of communication and cognitive disorders. In addition, Jody has a passion for working with adults looking to achieve clearer communication. Jody received her BS in Speech and Hearing Sciences and MS in Medical Speech-Language Pathology from the University of Washington. She was a part of the Lucile Packard Children’s Hospital at Stanford’s cleft and craniofacial clinic participating in the multidisciplinary assessment and treatment of children born with craniofacial abnormalities. She holds a staff position at UCSF and is the lead speech language pathologist for the department of Otolaryngology-Head and Neck Surgery’s Hearing Loss Clinic. When she's not busy having fun with her clients Jody enjoys spending time with her husband, Anton, friends and family. And if she's not headed out somewhere fun for dinner, you might find her at Bar Method working out!