• zInternationalStudents Blog

  • Tuesday, September 26, 2017

  • Filing health insurance claims - Part 2

    Filed Under: Health Insurance

International students who are not used to the American health insurance terminologies might find it difficult to succinctly understand some words that are used in a very matter-of-fact way on websites and by health insurance agents. Following up on a previous post, we continue our journey in understanding the claims process for health insurance, by concentrating on some terms.

Making sense of the jargon

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  1. Health Insurance Claim: Simply speaking, a claim is a bill that your doctor or emergency room or some other health care facility sends to your health insurance company on your behalf. A claim is usually handled by the health care provider after you fill up a detailed form giving your insurance information.
  2. Co-pay: Depending on the the kind of policy you have taken, there are two scenarios possible. Either the entire bill is sent to the insurance company, or a part of the bill (say 75%) is billed to the insurance provider and you pay the rest. The clause that deals with part payment out of your pocket is called a co-pay clause. In case your policy has a co-pay or co-insurance clause, you have to pay the percentage or dollar amount that you have agreed upon, and the rest is settled by the insurer.

In further articles, we try to clarify some more jargon; after which we move on to the actual claims process.

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