Glossary of Terms

Primary Care: primary care providers (family medicine, internal medicine, pediatrics) see patients for well visits and sick/injury visits, and make referrals for patients to see specialty care providers (gynecology, dermatology, allergy, nutrition, etc.)

Health Care Provider: a physician, psychologist, counselor, nurse or physician assistant who may be providing care during your visit.

Premium: regular payments to your health insurance company to keep your health care plan active.

Deductible: the total amount you pay “out-of-pocket” to your health care provider for covered services before your health plan kicks in to pay for ongoing treatment.

Copayments: “out of pocket” fees you pay to your health care provider for certain visits.

Coinsurance: is the percentage of covered medical expenses that you pay. Your coinsurance plus the insurance company’s coinsurance are made to the health care provider.

Provider Network: group of physicians, hospitals, and other health care providers that have agreed to provide medical services at pre-negotiated rates with the insurance company. Note: in general, provider services “in network” (designated care providers or preferred care providers) are covered at the highest percentage.