Frequently Asked Questions
Insurance Terms Glossary
To help you better understand insurance terms, we have created a glossary below.
The dollar amount agreed upon, by contact, between your provider and your health insurance company.
The percentage of costs of an insurance-covered service paid by you after your deductible is met. For example, you might be responsible for 20% of the allowed amount once your deductible is met.
A fixed amount you pay for an insurance-covered service. For example, your plan might have a $20 copay for an office visit or a $100 copay for surgery. Copays often vary depending on where a service is performed. For example, in an office setting versus in a surgical center.
The amount you pay to healthcare professionals for covered services before your insurance company begins to contribute towards the costs. Many plans may require the deductible to apply to your vasectomy. We have found this to be particularly true of insurance plans with high deductibles and/or HSA’s (defined below).
Family Planning Services
All birth control services provided by doctors, including vasectomy. Many plans cover these services under a preventive option, at no cost or a minimal cost to you.
FSA - Flexible Spending Arrangement
Also known as a Flexible Spending Arrangement. An IRS-approved medical funding account that you put pre-tax money into and then use to pay for certain out-of-pocket health care costs. Employers can, but are not required to, make contributions to FSAs.
Typically, you must use the money in an FSA within the plan year. Funds do not usually carryover to the next year, though some employers may offer a grace period that extends into the new year. They might also allow a limited amount to be carried over and used the following year.
Health Care Professional
A person licensed to give medical care to patients.
HMO – Healthcare Management Organization
A type of health insurance plan that only pays for care provided by in-network doctors, who work for or contract directly with the HMO. These plans generally do not cover care by out-of-network doctors for a vasectomy.
HRA – Health Reimbursement Arrangement
An IRS-approved, employer-funded health benefit used to reimburse employees, typically tax-free, for out-of-pocket medical expenses and health insurance premiums.
HSA - Health Savings Account
An IRS-approved medical savings account type that lets you set aside pre-tax money you can use to pay your share of qualified medical expenses. HSA plans have at least a $1400 individual deductible and/or a $2800 family deductible. The cost of a vasectomy is usually applied to your deductible. Unused HSA funds will roll over to the following year.
Narrow Network Plan
A lower premium insurance plan that offers you a small (or a limited) network of providers. If the plan considers our doctors out-of-network, your cost to see us may be higher.
POS Plan– Point of Service Plan
A plan for which you pay less if you use providers that belong to that plan’s network. These plans generally require a referral from your primary care doctor for a vasectomy. Benefits are based on where you receive healthcare services. For example, at a doctor’s office, hospital, or another facility.
PPO – Preferred Provider Organization
The amount you pay to your insurance company for your health insurance each month.
A person, group, or institution who provides a product or service.
Frequently Asked Questions
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