► I'M A MEMBERUnderstanding Benefit Plans

Understanding Your Benefit Plan


Starting October 1, 2013, all private health insurers were required to provide consumers with clear, consistent and comparable information about their health plan benefits and coverageSummary of Benefits and Coverage (SBC). To find your plan's Summary of Benefits and Coverage, start at Individual and Family Plans.

The purpose of the SBC is to provide consumers with standard information so they can compare plans side by side. The information will be laid out in the same way, using the same presentation and languageit’s like a nutrition facts label for health insurance stating exactly what the plan does and doesn't cover.

The SBC summarizes the key features such as the covered benefits, cost-sharing provisions and coverage limitations and exceptions. The eight-page form displays information about a health plan in a simple question-and-answer format.  It answers questions like: 

  • What is the overall deductible?
  • Is there an out-of-pocket limit on my expenses?
  • Does this plan use a network of providers?
  • Are there services this plan does not cover?


If you would like to learn more about key features of a plan’s SBC, you may find the following ConsumerReports' report on SBC helpful.
 

Information on our NEW MyDoc HMO Platinum Extra Value Plan

If you would like to learn more about our Platinum Extra Value Plan, select Massachusetts or New Hampshire.

 
 

Glossary of Health Coverage and Medical Terms


The Center for Medicare and Medicaid Services glossary defines many commonly used terms, but isn’t a full list. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan or health insurance policy. Some of these terms also might not have exactly the same meaning when used in your policy or plan, and in any case, the policy or plan governs.

For glossary terms and definitions specific to your Minuteman Health membership refer to your Explanation of Coverage (EOC) or your Summary of Benefits and Coverage (SBC).

CMS Glossary of Health Coverage and Medical Terms