I’ve had the wonderful fortune to remain on my parents’ health insurance coverage throughout my life.
However, I turned 26 this year.
So, when my company’s open enrollment season began, it was time for me to spread my wings and choose my own plans.
It was intimidating to click the link to choose a plan, and it only grew worse as I went through the decision process.
What is a Health Savings Account (HSA)?
Or even an FSA?
Was that really necessary?
And, in terms of a plan, what did a high deductible vs a low deductible mean?
Overwhelmed, I sought assistance from specialists.
One piece of advice they gave me was to grasp the enrollment lingo before beginning your search for a health-care plan.
So, here’s a dictionary of terms compiled by USA TODAY, along with extra information to assist you in making an insurance decision.
Health insurance: I was nervous about enrolling in my first health plans, so I sought expert assistance on open enrollment.
A glossary of phrases to be familiar with when shopping for health insurance
According to HealthCare.gov, the premium is the monthly amount you pay for health insurance.
It’s the starting point, and it usually doesn’t cover much else.
Various plans have different premiums.
A greater deductible means a lower premium, and vice versa.
A deductible is the amount you pay in out-of-pocket expenses before your health insurance plan kicks in.
When a deductible is met, insurance will cover the majority of the expenses.
Co-payment: A co-pay is the amount you pay at the doctor’s office.
According to HealthCare.gov, it’s a “set amount ($20, for example) you pay for a covered health care service after you’ve paid your deductible.”
According to HealthCare.gov, the visit cost is the “maximum amount a plan will pay for a covered health care treatment” that you will pay under your health care plan before you reach your deductible.
If you haven’t met your deductible, you may be able to pay $100 for a covered service within the authorized amount rather than a $20 co-pay, according to the agency.
Employees can contribute to a Health Savings Account (or a health plan with a lower monthly premium) if they choose a High Deductible Health Plan (or a health plan with a lower monthly premium), which allows them to save money for health expenses tax-free.
An HSA is “a form of savings account that allows you to set aside money on a pretax basis to pay for eligible medical expenses,” according to HealthCare.gov.
HSA funds are tax-free and can be used to pay for deductibles, co-pays, and other health-related charges, lowering overall health-care costs.
The money in an HSA can’t usually be used to pay for premiums.
FSA (Flexible Spending Account): An FSA is similar to an HSA in that it allows the user to utilize pretax cash to pay for out-of-pocket medical expenses such as co-pays, prescription medicines, medical equipment, and insulin, among other things.
Employers will give consumers two alternatives if the money is not spent by the end of the year, according to HealthCare.gov: take 212 additional months to utilize the money in the account or carry $500 over to the next year.
In-Network vs. Out-of-Network: When a doctor or facility is “in-network,” it indicates they are part of a health-care plan’s network.
Because in-network providers have contracts with the insurer, in-network providers typically cost less to the insured than out-of-network providers.
Specialist: Not all doctors are covered in the same way by insurance plans; specialists are frequently more expensive to see, with insurers covering a portion of the cost.
A specialist is a doctor who “focuses on a certain area of medicine or a group of patients to diagnose, manage, prevent, or cure certain types of symptoms and illnesses,” according to HealthCare.gov.
Non-physician specialists with advanced training in a particular field of medicine are also available.
Preventative services: According to HealthCare.gov, preventative care appointments, also known as “preventative services,” are routine appointments such as screenings, checks, and other procedures aimed at preventing disease or other health concerns.
Other resources for learning about open enrollment
There are many resources available online for anyone who want to learn more about health insurance and open enrollment.
HealthCare.gov, for example, contains a comprehensive vocabulary of terms and services such as plan comparison guides.
It’s also a good idea to look into any open enrollment resources supplied by your workplace.
My firm provides us with access to a bot named “Alex,” who acts as a digital counselor, explaining each plan, its pricing, perks, and how to choose the best plan for your needs.