All The Health Insurance Terms That You Need To Know

Having health insurance is necessary, but things can be confusing when you start coming across the different terms that they use. Familiarizing and knowing these health insurance terms will help you choose the best insurance for you and your family.

With the Affordable Care Act, people will be able to understand insurances easier. Plus, getting health insurance won’t be a problem because this act is helping people understand the concepts and new terms. So I’ve rounded up the insurance terms that you should know about before signing that policy.

1. Affordable Care Act

The Affordable Care Act is also known as the Patient Protection or Obamacare. This is a legislation that was signed in 2010 by President Obama. The provision of this law includes universal coverage, which is now in place. There are still some coverages that will be rolled out in the coming years.

2. Cancellation

There are insurance companies who have the right to cancel your health coverage. Under the law of ACA, these insurance companies will no longer be able to do that. But if you purposely commit the mistake or you start skipping your payments, then cancellations may be applied.

3. Copayments

Copayments are the fixed amount of money that you should pay from your pocket for service. The amount will usually range from $15 to $20. You can pay this at the office of your provider.


COBRA or Consolidated Omnibus Budget Reconciliation Act of 1985 is a law that will give you the right to temporarily continue with the group insurance under your employer, even after leaving the job. This counts even if you left involuntarily or voluntarily.

5. Dependent Coverage

There are also insurance plans that will give coverage to the policyholder’s family members. There will also be a dependent coverage that will let your children be covered until they reach 26 years old.

6. Deductible

The deductible is the money that you need to pay before your health insurance takes place. The amount will be calculated on an annual basis. Usually, if you pay a high deductible, the monthly premium will be lower.

7. Drug Formulary

These are all of the medications that should be covered by your health insurance plan.

8. Grandfathered Health Plans

This is an individual or group health plan which were bought on or before the 23rd of March 2010. All of these plans will be exempt from a lot of the Affordable Care Act’s provisions.

9. Essential Health Benefits

The ACA will require specific health plans for small groups and individuals to offer a comprehensive package of services and items. These benefits include newborn care, maternity, hospitalization, mental health, substance use disorders, and pediatric care. All of these are under the Affordable Care Act, which was in effect since 2014.


HIPAA or also known as the Health Insurance Portability and Accountability Act is a law that will know the standards for handling information about health. It also includes your rights to certain confidentiality to protect any of your information when it comes to your health.

11. Health Care Plan Categories

The health care plans are divided into four different categories, which are the Platinum, Gold, Silver, or Bronze. Your plan will be categorized depending on how much you are paying for the plan. If you want the most coverage, then it would be ideal for getting the premium plan. Bronze usually offers less coverage.


These are all the health insurance terms that you should be aware of before signing up for your health care policy. Familiarizing yourself with this information will help you understand everything that comes with your insurance.

Based on Materials from Health.Com
Photo Sources: Econ Talk, KNOE, Australian Institute of Family Studies