FAQs
1What does a deductible mean in health insurance?
Deductible in health insurance is the amount of money you’re required to spend before certain healthcare services are covered by your health insurance policy.
2What does “after deductible” mean in health insurance?
“After deductible” in health insurance means that a specific healthcare service is covered only after you meet your deductible.
3What does “before deductible” mean in health insurance?
“Before deductible” in health insurance means that a specific services is covered even before you have met your deductible.
4What’s a copay in health insurance?
In health insurance, copay is a fixed amount you have to pay for a healthcare service, with your health insurance covering the rest.
5What does coinsurance mean in health insurance?
In health insurance, coinsurance is a percentage of the cost of a healthcare service to have to pay, with your health insurance covering the rest.
6What does out-of-pocket maximum mean in health insurance?
Out-of-pocket maximum (OOPM) is the total amount you have to pay for your healthcare before your insurance policy covers 100% of the rest over the course of a policy year (excluding premium payments). To learn more, read the article we wrote about OOPM. Click Here
7What does Special Enrollment Period (SEP) mean in health insurance?
During the Special Enrollment Period (SEP), you need to have a Qualifying Event (QE), such as loss of employer-sponsored coverage, to be able to buy a health insurance policy.
8What does Qualifying Event (QE) mean in health insurance?
A Qualifying Event (QE) is something that happens in your life that allows your sign up for health insurance after the Open Enrollment period ends. Examples of Qualifying Events include losing employer-sponsored coverage, having a baby, and moving from out-of-state to in-state.
9How many employees do I need to have to qualify for group health insurance?
To buy a group health insurance policy, you have to have at least one fulltime W-2 employee that isn’t the company owner or their spouse. Fulltime is defined as 30 hours per week or more.
10Do I have to pay for part of my employees’ health insurance when I offer group health insurance?
Yes. You have pay at least 50% of the cost to cover the employee for the lowest cost plan you offer. You don’t have to pay any of the cost for the employee’s dependents.
11What does dependent mean in health insurance?
A dependent means either a spouse/domestic partner or child under the age of 26. Child included adopted and stepchildren. You may also be able to cover a grandchild, foster child, adult child with a disability, or if you are someone’s legal guardian.
12How can I find out if my doctor takes my insurance?
The best way to find out is to use your insurance company's "Find a Doctor" tool. We've have a handy list of all those web pages here.
