Your Guide to Understanding Insurance Vocabulary

Insurance can be tricky even for the most intelligent consumers!  Here are some new vocabulary words to help you sound like an insurance consuming genius in no time!

Deductible: This is the amount you have to pay out of pocket, directly to your provider before your insurance begins covering your services.  How does your insurance know what you pay? You sly genius, you’re already picking up on it! Our billing assistant Gwen, aka organization ninja, sends over a bill to your insurance company.  They assume, correctly, that you’ve paid your bills and are adulting at the highest of levels. Once you’ve met your deductible your insurance kicks in and starts paying a percentage of your services.  You will likely still owe a co-pay for your future sessions.

Co-pay:  This is the amount you pay per visit to see your provider, after your deductible is met.  I know, it’s unfair, nothing in life is free. You’ll pay this amount at the time of your visit and it’s usually the same amount you’d pay at your doctor visits. If you’re not sure what your copay is, put that smart phone to use and call the nice people at your insurance company, they’ll be happy to tell you the amount you’ll owe when visiting us.  If the insurance person asks what CPT code we use it is typically 90837. (Google: CPT codes, if you suffer from insomnia they’ll put you straight to sleep)

Health Savings Account (HSA):  This is a debit card that can only be used to cover health costs.  We don’t make the rules and all agree that shopping is a form of therapy too, but your HSA card won’t work at your favorite store.  All of the money you put in your HSA account is tax free and a great way to pay for therapy and save a little cash on taxes, who doesn’t like that deal?!

EOB:  This is a short way of saying, Explanation of Benefits.  You’ve probably seen one of these before from your insurance company, you’ll be getting one in the mail from your insurance carrier that will account for your visits with us.  If you can decipher the details on this statement (which I trust you can after learning all of these new vocabulary words!) you’ll be able to know: 1. Your copy amount. 2. How much more you have to pay before your deductible is met. 3. How much the insurance company has paid your provider.  If you want to go to Mensa Insurance Understanding levels read the definitions for the codes on your statement.

Finally, call your mom, your boss, or anyone else you want to impress and let them know you received a gold star in adulting today since you finished reading this page!