Health insurance can be a tricky topic, and keeping up with all of the jargon can be difficult. To assist you, we've compiled a list of common health insurance terms and definitions. Continue reading to find out more!



Premium: The premium is the amount that you pay for your health insurance every month. This amount is typically deducted from your paycheck if you have employer-sponsored health insurance, or you can pay it directly to your insurance company if you have an individual plan.



Deductible: This is the amount of money that you are required to pay out-of-pocket before your health insurance policy begins to cover expenses. For example, if your deductible is N10,000 and you incur medical expenses of N15,000, you will only have to pay N10,000 because your health insurance will cover the remaining N5,000.



Co-payments (co-pays): This is a fixed amount that you pay for a covered medical service, usually when you receive the service. For example, you may have a $20 co-pay for a doctor's visit or a $5 co-pay for a prescription drug.



Co-insurance: This is the percentage of covered medical expenses that you are responsible for after you have met your deductible. For example, if your co-insurance is 20% and you incur medical expenses of N100,000, you will only have to pay N20,000 because your health insurance will cover the remaining N80,000.



Network: Most health insurers have a network of doctors, hospitals, and other healthcare providers that they have negotiated lower rates with. If you use a provider that is in your insurer's network, your out-of-pocket costs will typically be lower than if you use a provider that is not in your insurer's network.



Out-of-pocket limit: Your out-of-pocket limit is the maximum amount of money that you will have to spend on covered medical expenses in a year. Once you reach this limit, your insurance company will start paying 100% of the costs of covered services.



Pre-existing condition: This is a medical condition that you had before you obtained your health insurance policy. Pre-existing conditions typically are not covered by health insurance policies.



In-network vs. out-of-network providers: In order to keep costs low, most insurance plans have a network of doctors and hospitals that they have negotiated lower rates with. If you see a provider who is in-network (i.e., contracted with your insurance company), then you will likely pay less than if you saw an out-of-network provider.



Provider: A provider is any individual or institution—such as a doctor, hospital, or laboratory—that provides healthcare services.



Preauthorization/precertification: These are procedures that must be approved by your insurance company prior to receiving treatment in order for them to agree to cover the costs associated with the procedure



Portability: Portability refers to the ability to keep your health insurance coverage when you change jobs or leave your job altogether (e .g., retirement). In Nigeria, portable health insurance plans are offered by private companies and some public sector organizations.



Benefits packages: A benefit package is a set of benefits—such as health, dental, and life insurance —offered by an employer to their employees. Typically, employees are required to pay some or all of the costs associated with these benefits.



Now that you know the basics, it’s time to get started on your health insurance journey. Sign up for free today on roHealth and let us help you find the best coverage for you and your family. We’ll keep you updated on all the latest health insurance news and changes, so you can make informed decisions about your coverage. Thanks for reading!

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