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Provider: Provider is a term used for health professionals who provide health care services. Sometimes, the term refers only to physicians. Often, however, the term also refers to other health care professionals such as hospitals, nurse practitioners, chiropractors, physical therapists, and others offering specialized health care services.

Primary Care Provider (PCP): A health care professional (usually a physician) who is responsible for monitoring an individual’s overall health care needs. Typically, a PCP serves as the gatekeeper for an individual’s medical care, referring the individual to more specialized physicians for specialist care.

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Terms to know

Deductible
Generic / Brand Name Drugs

Out of Pocket Maximum
Co-Payment
Co-Insurance
In/Out of Network
Explanation of Benefits
Exclusion
Outpatient
Pre-existing Condition

Plan Types

PPO / HMO / POS
Short Term Medical
High Deductible Plan
Health Savings Account

 

 

 

 

 

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