Having a reliable health insurance policy protects you from high and unexpected costs when accessing medical care. If you're shopping for a new policy, reading the agreement in detail can present several terms that you are unfamiliar with. These words and phrases can be confusing if you don't have a background in insurance, and understanding them thoroughly ensures you get the correct coverage. Below are several lesser-known terms that you should learn about.

What Are Some Important Health Insurance Terms?

1. Coinsurance

This term refers to the percentage of medical expenses you are responsible for paying after meeting the deductible. It is calculated as a portion of the allowed service amount. For example, if you have a coinsurance amount of 20%, and your doctor orders a test that costs $300, you must pay $60. Then, your insurer pays the remaining balance of $240. This offsets the cost of treatment to make it more affordable for you. If you don't want to pay much out of pocket, opt for a policy with a lower coinsurance amount.

2. Open Enrollment

Open enrollment refers to the annual period in which you can sign up for health insurance or make changes to an existing plan that you have through the individual marketplace. This is the only time of year you can switch plans, add covered individuals to an existing policy, or apply for financial assistance programs. In Ohio, as in most states, open enrollment for 2022 runs from November 1, 2021, to January 15, 2022.

3. Out-of-Pocket Max

This is the amount of annual health insurance costs you must pay apart from monthly premiums. It includes coinsurance, copays, and deductibles, and it is capped at a certain amount, which differs between plans. As soon as you meet the out-of-pocket maximum for the year, the insurer picks up all remaining costs of covered care. The lower this amount, the less you must pay each year for care.

4. Schedule of Benefits

A schedule of benefits details the costs of care services covered by your health insurance plan. It includes copays, coinsurance, deductibles, and out-of-pocket maximums. This gives you an idea of what services the coverage pays for and how much you may be responsible for. For example, if you need specialized treatment for a condition, you want a plan with a schedule of benefits that specifically covers the cost of this type of care.

If you need help navigating the health insurance marketplace and finding care that meets your needs, contact Divine Insurance Solutions in Dayton, OH. They provide health, dental, and vision insurance policies for residents and small businesses. They are an independent agency that strives to provide the best plans and most affordable rates available. Call (937) 479-1208 to request a quote, and visit the website to browse their services.