Birke Health Agency
Birke Health Agency
  • Home
  • blog
  • LEARN
  • About Us

Premium

 Your monthly payment to maintain health insurance coverage, regardless of whether you use medical services. 

Copayment (Copay)

 A fixed dollar amount you pay for specific services (e.g., $30 for a doctor visit) with insurance covering the remainder. 

Health Savings Accounts

Save money on your healthcare expenses and build a nest egg for future medical needs with our health savings accounts. Get tax benefits while taking control of your healthcare costs.

Coinsurance

 Your percentage share of costs after meeting the deductible (e.g., you pay 20%, insurance pays 80%). 

Out-of-Pocket Maximum

 The most you'll pay for covered services in a plan year. After reaching this limit, insurance pays 100% 

Network

 The doctors, hospitals, and providers contracted with your insurance for negotiated rates. Using in-network providers costs less. 

Prior Authorization

 Insurance company approval required before certain services or medications are covered. 

Formulary

 List of prescription drugs covered by your insurance plan, often organized in tiers with different costs. 

Explanation of Benefits (EOB)

 Document from your insurer showing what was billed, what they paid, and what you owe. Not a bill. 

HSA/FSA

 Tax-advantaged accounts for medical expenses. HSA (Health Savings Account) rolls over yearly; FSA (Flexible Spending Account) typically doesn't. 

Explanation of Benefits (EOB)

 Document from your insurer showing what was billed, what they paid, and what you owe. Not a bill. 

Deductible

 The amount you must pay out-of-pocket for covered healthcare services before your insurance begins to pay. Resets annually. 

Subsidy/Premium Tax Credit

 Government financial assistance to reduce monthly premium costs for qualifying individuals through ACA marketplace plans. 

Birke Health Agency

800-318-2797

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Accept