Now that open enrollment is behind us, you may want to consider sending your employees a follow-up email or postcard reminding them of key health care terms they need to know. This type of information helps make employees better health care consumers so they can make the most of their medical coverage.
To help you get started, we’ve created a short list of health care terms to include. Of course, you’ll want to use terms specific to the medical plans you offer.
Terms to Consider
Copay — A fixed amount (for example, $15) you may pay for certain covered health care services (for example, a doctor visit). In-network copays usually are less than out-of-network copays.
Coinsurance — The percentage you pay for medical care after meeting the annual deductible.
Deductible — The amount you pay each year before the plan begins paying for covered medical and prescription drug expenses.
Annual out-of-pocket maximum — The maximum amount you pay each year for covered medical and prescription drug services, including your deductible, coinsurance and copays costs.
Out-of-pocket costs — Your medical expenses that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance and copays for covered services plus any costs for services not covered.
Generic drug — A drug equivalent to its brand-name counterpart because it contains identical active ingredients in the same dosage. Generic drugs usually cost less than brand-name drugs, and the Food and Drug Administration (FDA) rates generics to be as safe and effective as brand-name drugs.
Formulary — A list of brand-name drugs chosen for their effectiveness, safety and cost.