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A type of health insurance plan that provides more flexibility when picking a doctor or hospital. PPOs often provide coverage for care obtained both inside and outside the network.

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency.

The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.

A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require a referral from your primary care doctor to see a specialist.

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

A request for payment that you or your health care provider submits to your health insurer when you get items or services you think are covered.

The amount you pay out-of-pocket for covered health care services before your insurance plan starts to pay.

A health problem you had before the date that new health coverage starts.

A list of prescription drugs covered by a prescription drug plan or other insurance plan offering prescription drug benefits.

The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan's network (except in an emergency).

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.$

Your share of the costs of a covered healthcare service, calculated as a percentage (like 20%) of the allowed amount for the service.

A statement from your health insurance company providing details on payment for a medical service you received, summarizing what the insurer paid and what you owe.