WPS Health Insurance

WPS Health Insurance, a Leading Provider of Individual Health Insurance, Aims to Help Consumers Learn the Language of Health Insurance

New article from Wisconsin's leading not-for-profit health insurer demystifies 33 common industry terms

MADISON, Wisconsin
June 30, 2011

No doubt about it, the language of health insurance can be hard to understand. Yet every day, it's becoming more and more important for health care consumers to have at least a basic knowledge of the industry's terminology. That's why WPS Health Insurance, Wisconsin's leading not-for-profit health insurer and provider of affordable individual health insurance and group health insurance, has assembled a helpful list of plain-English definitions for 33 of the most commonly used health insurance terms.

"Once consumers grasp the industry's basic terminology, health insurance becomes a lot less scary, and much easier to understand. At WPS, we want to help consumers remove the barriers that keep them from participating fully in the critical decisions that affect their health and their pocketbooks."

— Tom Olson, Senior V.P. of Sales and Marketing, WPS Health Insurance

Some of the terms WPS explains include:

one of the ways people share in their medical costs. The patient pays a flat fee for certain medical expenses (e.g., $10 for every visit to the doctor), while their insurance company pays the rest.
the amount of money someone must pay each year to cover medical expenses before their insurance policy starts paying.
Explanation of benefits
the health insurance company's written explanation of how a medical claim was paid. It contains detailed information about what the company paid and what portion of the costs the individual is responsible for.
Medicare supplement plans
plans offered by private insurance companies to help fill the "gaps" in Medicare coverage.
the group of doctors, hospitals, and other health care providers that insurance companies contract with to provide services at discounted rates. Consumers will generally pay less for services received from providers in network.
coverage options that enable people to expand their basic insurance plan for an additional premium. A common example is a maternity rider.
the process by which health insurance companies determine whether to extend coverage to an applicant and/or set the policy's premium.

Twenty-six more terms are explained in the full article, "Health Insurance 101: Health Insurance Terms and Definitions," which is available for free in the Learning Center on the WPS Health Insurance website.

WPS encourages health care consumers who have questions about these terms, their own coverage, or any other health-insurance-related questions, to call 888-245-4197 and talk with a friendly WPS representative today.

About WPS Health Insurance
Founded in 1946, WPS Health Insurance is Wisconsin's leading not-for-profit health insurer, offering affordable individual health insurance, family health insurance, high-deductible health plans, and short-term health insurance, as well as flexible and affordable group plans and cost-effective benefit plan administration for businesses. In addition, the WPS Medicare division administers Part A and B benefits for millions of seniors in multiple states, and the WPS TRICARE division serves millions more members of the U.S. military and their families. For more information about WPS Health Insurance, visit www.wpsic.com.