ESL Podcast 676 - Selecting a Health Insurance Plan

open enrollment - a period of time once a year when employees can sign up for one of several health insurance plans and other benefits offered by the employer

We won't be allowed to change our health insurance plan until the open enrollment period.

to switch - to change; to stop using or having one thing and start using or having another thing

Cherise switched cell phone providers because she found out another company offered better coverage.

health plan - a health insurance policy; an arrangement where an individual or an employer pays a certain amount of money each month and a health insurance company pays a certain percentage of his or her medical costs

Does your health plan pay for this type of surgery?

HMO - health maintenance organization; a type of health plan where individuals receive most of their health care from a primary care doctor who provides referrals to other specialists when needed

Under the HMO, you'll need to go to your primary care physician for everything, whether you're just sick, have a broken leg, or need skin treatment.

PPO - preferred provider organization; a type of health plan where individuals can see any of the doctors within a particular group of doctors and clinics, without getting a referral first

Xander loves his PPO because he can make appointments with specialists without first needing to see his regular doctor.

network - a large group of related people, organizations, or things that are connected in some way

Which cell phone network provides the best coverage in mountain areas?

dependent - a person who relies on another person for financial support and other benefits, often a young person who is still reported on his or her parents' taxes and receives benefits through his or her parents' health insurance policy

Most children don't need to file tax returns as long as they are claimed as a dependent on their parents' tax returns.

literature - printed material describing something and providing information, often as brochures

Dr. Sanchez gave Ilia a lot of literature about different treatment options.

to make heads or tails of (something) - to be able to understand something that is very confusing and complex

Lauren says she can't make heads of tails of the new application forms.

coverage - the protection or extend of services provided by an insurance company

Our health insurance policy provided full coverage for having a baby.

pre-existing condition - a medical condition or health problem that one had before signing up for a particular health insurance policy

Most insurance companies won't pay for any treatments related to pre-existing conditions.

prescription drug - a medicine that cannot be purchased without a doctor's written prescription (instructions for the pharmacist)

Olivia takes a prescription drug for her headaches, because medicines she buys at the drugstore aren't strong enough.

out-of-pocket - the portion of medical costs that an individual with health insurance has to pay; the medical expenses that are not covered by health insurance and must be paid by the individual

The Hansons have an annual out-of-pocket maximum of $10,000 for the entire family.

don't look at (someone) - a phrase used to show that one does not want to be consulted or asked about something, usually because he or she has no knowledge or information about the topic, or because one does not want to be involved

When Betty realized that her wallet was missing, she thought I may have taken it, but I said, "Don't look at me! I've never touched your wallet."

copay - the amount or percentage an individual must pay each time he or she receives some medical service, with the rest being paid by the health insurance company

Gerhard has to pay a $25 copay each time he sees his doctor.

deductible - the amount of money an individual or family must pay in a year before health insurance begins to pay for anything

They bought health insurance policy with a $1,500 deductible, so they have to pay the first $1,500 of any medical bills, but their health insurance will cover anything beyond that.

to be on (one's) own - to need to do something alone, without receiving help from others

Ariana has been on her own since she turned 18 and her parents stopped helping her financially.

it's all Greek to me - a phrase used to show that one does not understand anything, usually because it is very complex or unfamiliar

I don't understand the instructions for assembling this desk. It's all Greek to me!