Making Benefits a Breeze. Easy to understand, easy to implement, easy to manage.
From copays to deductibles, HMOs and PPOs, find clarity in insurance term literacy. Learn the lingo with this easy-to-understand glossary of the most commonly used (and misunderstood!) words and phrases.
Learning the lingo
The maximum amount the dental insurance plan will pay out towards your claims in the calendar year of your policy.
Your percentage share of cost for a covered health care or dental service, after the deductible has been met.
A fixed dollar amount for an office visit with a physician or a prescription.
A specified amount of money you pay for covered health care services before your insurance plan starts to pay.
Contacts for members who can elect to wear glasses or contacts.
A health plan that requires a member to choose a primary care physician (PCP) that is part of their designated network. PCP referral is required for specialty services (e.g., dermatology, labs, diagnostic).
Contacts for members whose vision cannot be corrected with glasses.
The most you could pay in a calendar year for In-Network covered health care services.
A health plan that allows patients to choose any physician or specialist, either inside or outside their network. Out of network providers will result in higher costs.
Standard lenses have a line separating the different vision corrections (e.g. bi-focal or tri-focal). Progressive lenses include different vision corrections without the visible line.
If your plan covers the 90th% UCR charge, that means out of network claim are paid based on what 9 out of every 10 dentists in your local area charge. You are responsible for any balance above that amount.
Making Benefits a Breeze. Easy to understand, easy to implement, easy to manage.