Glossary of Terms
An HDHP gives you more control over how you spend health care dollars and takes the least amount of money out of your paycheck. This medical plan allows you to see any provider, but you should make sure your doctor is in-network for the biggest savings. You must pay for the cost of all services until you meet the annual deductible, when the plan starts to share costs. You’re also eligible to participate in a tax-advantaged Health Savings Account (HSA).
This is the most that you could potentially pay out-of-pocket during the year, depending on your coverage tier. After you reach the out-of-pocket maximum, the plan will pay the rest.
A predetermined dollar amount you pay for visits to the doctor, prescriptions and other health care services (as specified by your plan).
The amount of money you need to pay out-of-pocket before your insurance begins contributing money to your health care costs (except where copays apply).
The percentage you pay for the cost of covered health care services after you’ve met your deductible. For example, if the coinsurance under your plan is 20%, you would pay 20% of the cost of the service and your insurance would pay the remaining 80%.
An HSA is a personal savings account for qualified health care expenses available only if you’re enrolled in an HDHP. You choose how much of your paycheck to set aside to pay for eligible health care expenses with tax-free dollars. Ensign contributes to your account too (if you contribute at least $1/annually), so funds grow even faster! Additionally, your HSA funds are always yours, even if you switch jobs or retire.
- BCBSTX: $250 for individual coverage or $500 for family coverage
- Kaiser: $250 for individual coverage or $500 for family coverage
With an FSA, you decide how much of each paycheck to save for out-of-pocket medical, prescription, dental, vision or dependent care expenses for yourself and your eligible family members — even if you don’t cover them under the medical plan.
Some types of coverage require EOI, which is documentation of your health history. This could include a questionnaire, statement from your doctor, and a medical exam. Be sure to complete this confidential application when prompted to ensure your coverage is continued.