Q: What is a deductible?
A: A deductible is the amount you pay each calendar year before health insurance benefits are paid for covered medical expenses.

Q: When does my deductible start over?
A: Your deductible starts over each year on January 1st.

Q: What is coinsurance?
A: Coinsurance is the percentage of covered expense you are responsible for after you meet your deductible.

Q: What is a co-payment?
A: A co-payment is a set amount that you pay for a specific service, such as $25 for an office visit. You are usually responsible for payment at the time of service.

Q: What is the Doctor Office Co-payment (DOC) option?
A: Our DOC option lets you know up front exactly how much you'll pay for routine care. When you add the DOC option to your plan, your co-payment is all you pay for an eligible network office visit -- such as lab and x-ray, examinations, diagnosis, history of immunizations and allergy shots.

Q: What is individual out-of-pocket expense?
A: It's the maximum amount in covered charges you'll pay -- per person, per calendar year. The amount is determined by adding your deductible and coinsurance together. For instance, if you have a $1,000 deductible and 20% coinsurance of the next $5,000, the most you'll pay is $2,000.

Q: What is family out-of-pocket expense?
A: Like individual out-of-pocket expense described above, it's the combined total of your deductible and coinsurance, but for your whole family -- which is the maximum amount in covered charges you'll pay no matter how many members of your family collect insurance benefits.

Q: What is the difference between a network and non-network (or out-of-network) medical provider?
A: A network provider is a doctor or hospital that has made an arrangement with us to provide services at a discounted rate. Non-network providers have not arranged to provide services at a discounted rate for our customers. So you will typically pay less for services from a network provider than a non-network provider.

Q: What is a Preferred Provider Organization (PPO)?
A: A PPO is a large group of doctors and hospitals that have agreed to provide their services to our customers at a discounted rate. Buy a PPO plan to reduce your premium and out-of-pocket costs.

Q: What is a Health Savings Account (HSA)?
A: A Health Savings Account (HSA) is an account that works like an Individual Retirement Account (IRA), except the money saved is earmarked for future health care costs.

• Anyone who buys a qualified high deductible health plan (one that meets the requirements the government has determined), with at least a $1,000 single or $2,000 family deductible, qualifies for an HSA.
• The money you deposit into your Health Savings Account, as well as the earnings, is tax-deferred. You can withdraw money at any time to pay for qualified medical expenses, without being penalized.
• You can even roll over unused balances from year to year.

Q: What is an indemnity plan?
A: An indemnity plan, also called a traditional health insurance plan, gives you the freedom to choose any doctor or hospital for your care. And since an indemnity plan isn't associated with any network, you won't pay any penalty for choosing a particular doctor or hospital. Premiums for an indemnity plan are higher than PPO plans.

Q: Different plans have different lifetime benefit maximums. What does that mean?
A: The lifetime benefit maximum is the total amount a plan will pay out for as long as you own it. While it's rare for claims to exceed a $2 million maximum, it does happen. And if it happens to you, it's almost certain to bring serious financial hardship. You'll be glad to know we offer one of the nation's highest lifetime maximums -- up to $8 million.

Q: Intensive Care Unit (ICU) costs are expensive. What type of plan covers these costs?
A: We understand that this is one of the important questions asked when choosing a medical plan, that's why all of our medical plans will cover these costs, making your choice that much easier.

Q: What if I'm traveling and need care?
A: It's important to know whether a health plan provides coverage when you're abroad. With our worldwide coverage, services incurred outside the U.S. are covered the same as if they we're incurred in the U.S.

Q: Do all health plans offer the same benefits?
A: Not all health plans offer the same benefits. When shopping for health insurance, look for plans that offer a range of options. Within your budget, look for plans that cover the essentials and meet your individual needs.

Q: Do plans cover dental care, eyeglasses, contact lenses or hearing aids?
A: Generally, health insurance plans for individuals and families do not cover dental care (unless it's caused by an accident), eyeglasses, contact lenses or hearing aids.

Q: What prescription drug coverage options are available?
A: You can choose from several plans, which offer no deductibles or other plans which do.

Q: If my doctor prescribes a brand-name drug for me, will it be covered?
A: Depending on the plan you choose, you may have to pay a portion if a generic brand is available.

Q: Which plans include child preventive care?
A: Most plans cover baby and child wellness exams, as well as immunizations.

Q: How long can my dependent children remain on my policy?
A: The age at which dependent children cease to be covered varies, depending on the kind of plan you have, the state where your policy was issued and where you live. Disabled children may remain on a policy indefinitely. Call us for details.

Q: Why should I choose PhiDE Health Insurance Broker Service?
A: This service offers access to over 100 medical plan designs that are customized to fit your individual or family needs! Along with prompt and friendly service, we make finding health insurance easy!

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