Health Insurance in Washington State

What is Health Insurance & Why Do I Need It?

Health insurance covers medical expenses for illnesses, injuries and other health conditions. You need it because:

• Health insurance can help safeguard your family’s physical wellbeing and way of life.
• Health insurance can make getting care more affordable by giving you access to a network of doctors and hospitals that have negotiated lower rates with insurance companies.
• Health insurance can help protect your financial wellbeing.
• Having health insurance makes paying and tracking medical payments quicker and easier.
• Health insurance coverage is required by many schools, colleges and other organization.

Medical expenses are the #1 cause of bankruptcy. 

Understanding Health Insurance Terms

Health insurance has its own language. Once you get a grasp on some basic terms, health insurance will seem much simpler. Let’s start by defining these terms:

Premium: The amount you pay your health insurance company to keep your coverage active. Most people pay their premiums monthly.

Deductible: A set amount you have to pay toward your medical bills every year before your insurance company starts paying. It varies by plan and some plans have no deductible.

Co-payment or Co-pay: The flat fee you pay every time you go to the doctor or fill a prescription. It’s usually a relatively small dollar amount. Co-pays do not count toward your deductible.

Co-insurance: The percentage of your medical bill you are responsible for after you’ve paid your deductible (and co-pays). Unless you have a policy with 100% coverage for everything, you have to pay a co-insurance amount. For example: Let’s assume you’ve met your deductible. Now you have a $100 doctor’s bill. Your plan covers 80% ($80) of it. The co-insurance amount due to your doctor’s office is 20% ($20).

Out-of-pocket Cost: A cost you must pay. Out-of-pocket costs vary by plan and each plan has a maximum out of pocket (MOOP) cost. Consult your plan for more information.

These five terms are a good foundation for understanding health insurance lingo. There may be other insurance terms that are unfamiliar or confusing to you — and that’s OK. You can check this glossary for more terms and definitions.

And, of course, we at Applied Team Insurance are always here to help you.