Common Insurance Terms
AHP: Academic Health Plans.
Benefits: The health care items or services covered by an insurance plan. Your insurance plan may sometimes be referred to as a "benefit package."
Claim: An itemized bill for services that have been provided to a subscriber, a subscriber's spouse, or dependents.
Copayment: A fixed dollar amount you are required to pay for a covered service at the time you receive care.
Deductible: A fixed amount of the eligible expenses you are required to pay before reimbursement by your health plan begins.
In-Network: Covered services provided or ordered by your primary care physician (PCP) or another network provider referred by your PCP.
Maximum annual benefit: The maximum dollar amount your health plan will pay for a particular health care service or for all health care services provided to you during one year.
Out-of-Network: Services not provided, ordered, or referred by your primary care physician (PCP).
Preferred Provider Organization (PPO): A health plan that provides covered services at a discounted cost for subscribers who use network health care providers. PPOs also provide coverage for services rendered by health care providers who are not part of the PPO network; the subscriber generally pays a greater portion of the cost for such services.
Preventive services: Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.
Primary Care Physician (PCP): The physician you choose to be your primary source for medical care. Your PCP coordinates all your medical care, including hospital admissions and referrals to specialists. Not all health plans require a PCP.
SHIP: Student Health Insurance Plan.