Knowing the ins and outs of a health care plan can sometimes be difficult, if not confusing. To make things simpler, Atlantic Health - parent company of CentraState Medical Center, Chilton Medical Center, Goryeb Children’s Hospital, Hackettstown Medical Center, Morristown Medical Center, Newton Medical Center and Overlook Medical Center – has put together this list of terms that will help patients better understand their health insurance and pay their medical bills with confidence.

Subscriber (enrollee): the person who buys (or whose work buys) a health insurance plan.
Dependent(s): the subscriber’s spouse, civil partner, or children (up to age 26) who are covered through the same plan.
Beneficiary: the health care items or services covered under your health insurance plan.
Benefits: the health care items or services covered under your health insurance plan.
Excluded services: health care services that your health insurance plan does not pay for or cover.
Primary vs. secondary insurance company: some people are covered by two insurance plans. An example of this is when a child is covered on both of his parents’ plans. This “double” insurance does not mean that your health care is paid for twice. Instead, one plan is always called the “primary” and the other “secondary.” For children, this is decided by the “birthday rule” which says that the parent whose birthday falls first in a calendar year is generally the primary insurance.
Billing Pre-Approval (pre-authorization): permission from your insurance company to receive care. This may not be required by all insurance companies or for all services.
Claim (claim number): requests for payment that either you or your health care provider sends to the insurance company. If the claim is denied, you have the right to appeal to your insurance company.
Charge: the amount of money billed by the provider or facility for medical services; this is not always the same as the amount due from patient. You may receive a bill or letter from more than one provider for the same date of service.
Allowed amount/eligible expense: the amount your insurance company will pay for a service. If the provider charges a higher amount than the allowed amount, you (or any other insurance company you are covered by) may be responsible to pay the extra money.
Benefit: the amount your insurance company pays for a certain medical service.
Explanation of benefit (EOB): a letter from your insurance company telling you what was billed by the provider, the amount they have paid and the amount you owe.
Date of service: the day (or days) you received medical services.
Discount/adjustment: the dollar amount removed from your bill (from the charged amount) because of a relationship between your provider and the insurance company.
Amount due from patient: the amount you owe, after your insurance company has paid their share.

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