When selecting California health insurance coverage for yourself, for your family or for your employees, it always pays to read the summary of benefits. Many of the answers of your questions are in the summary of benefits portion of your health insurance policy. Make sure to learn some of the terminology used in health plan benefit summaries. Every health insurance plan has a summary of benefits and the terms used are always the same as to stay consistent. Learn them once and you can understand any plan. Below is a list of terms you will always find on the summary of benefits and what they mean:

1. Co-Pay: The co-pay is the amount an insured must pay for medical services or prescription drugs based on the design of the particular plan.

2. Deductible: Generally found with PPO plans. The plan deductible is the amount of out-of-pocket money an insured must pay before the insurance company will begin paying a co-insurance.

3. Co-insurance: Co-insurance is the amount of money (usually a percentage) that you are subject to pay for certain medical services such as in-patient or out-patient hospital services.

4. Maximum Copayment: Also known as maximum exposure. This is the most an insured can pay in a given calendar year. If an insured reaches this amount the insurance companies co-insurance kicks in at 100% with the exception of prescription drugs in some cases.

5. RAF: The RAF (Rate Adjustment Factor) is used only with small group health insurance plans. The RAF is how a small group plan rate is determined. 1.0 is a standard rating yet depending on the health status of a group the RAF may increase 10% or decrease 10%.

These terms are commonly found in every health insurance proposal. Here at ezhealthinsuranceca it is our duty to explain these to you so that you know exactly what it it that you are purchasing. To make the most out of your health plan and to be certain that you are getting your money’s worth, you should always make sure that you know all that you need to know about your health care plan before signing up.

Learn more about how you can make the most out of your California health insurance coverage by calling us at 888-202-9441. You can also email us at admin@ezhealthinsuranceca.com.

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