The Affordable care Act is a complex law, even for the experts. Not only does it contain ambiguous phrases and terms that can be interpreted in many ways, but also it has insurance jargon not easily understood by the layman. The very people that the Affordable care Act aims at enrolling. Whereas this article does not cover all the jargon used under the Affordable care Act, it’s imperative to understand the following crucial five terms.
Co-payment (s) simply is the fee a patient pays everything they receive a health service. For example, if your co-payment is $40, every time you visit a doctor, then you will make the same payment each time you visit the physician for a service. That being said, it is illegal for physicians to charge of Co-payment for certain services under Obamacare such as for preventive exams. The following is a comprehensive list of services that don’t require co-payments.
The provider network is basically a comprehensive list of Doctors, health care facilities and other providers recognized under Obamacare and by extension accepts the Obamacare insurance policy. A network usually rates are usually pre-negotiated. Although you can get medical services from other providers not in your network, it will result in higher charges.
3. Preventive Covered services
Under the Affordable Care Act, preventive covered services refers to services you are eligible for once you successfully sign-up for Obamacare. This service has been tailored made for children, Women and Men.
4. Grandfathered plans
This was health plans that were in effect before Obamacare was signed into law on March 23, 2010. Grandfathered plans retained its status quo with the passage of the Affordable Care Act. That being said, they can be tweaked to certain limitations without losing the grandfathered status. It is imperative to fully understand whether your health plans has a grandfathered plan or not as it has a bearing on the benefit you will receive.
5. Annual out-of-pocket Maximum
This is the maximum amount a patient pays towards health care cost in a single year. This comes after paying limits for co-insurance, deductibles and copays and then the insurance will step-in to for the remainder of your healthcare charges in the year. The annual out-of-pocket maximum varies under the four metal levels: Bronze, Silver, platinum and Gold.