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Health insurance terms you need to know for Affordable Care Act

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The Detroit Free Press reports:

Co-payment: A fixed amount you pay for a covered health service. Usually paid when you receive the service.

Deductible: The amount you pay for health care services your health insurance plan covers before your health insurance plan begins to pay.

The Health Insurance Marketplace (also known as the Exchange): Administered by the federal government at http://www.healthcare.gov. Designed to make buying health coverage easier and more affordable.

Navigators: People and organizations that are trained and certified to help you understand your health care options and help you enroll in a plan. Also known as certified application counselors.

Out-of-pocket costs: Expenses for medical care not reimbursed by insurance, including deductibles, coinsurance and co-payments for covered services, plus all costs for services that aren’t covered.

Premium: The amount you pay for your health insurance or plan. You and/or your employer typically pay it monthly, quarterly or yearly.

Qualified Health Plan: An insurance plan that is certified by the Health Insurance Marketplace, provides essential health benefits and meets other requirements, such as doctor visits, preventive care and prescriptions.

Shared responsibility payment: If you decide not to purchase insurance you will have to pay a tax penalty unless you qualify for an exemption. (Exemptions are available to a variety of people, including members of certain religious groups and Native American tribes, undocumented immigrants, incarcerated individuals, and people for whom health insurance is considered unaffordable.)


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