Healthcare 101

How to speak healthcare

Do you need a dictionary to understand your doctor or your health plan?

Maybe your doctor tells you: “Your elevated glucose levels may exacerbate your hypertension.” Translation: Your high blood sugar may make your high blood pressure worse. Or your health plan says: “Your prescribed medication is on our drug formulary.” In other words, it’s covered.

Many people find health terms confusing. Knowing what common health and insurance words mean can help you make better health choices for you and your family.

10 health terms made simple

Acute: An illness that starts quickly and doesn’t last long.

Benign: Something that isn’t harmful or cancerous, like a non-cancerous growth.

Biopsy: Taking a small piece of tissue to check if it’s cancerous.

Chronic: A long-lasting condition, like an illness that stays for a long time.

Comorbidity: Having two or more conditions at the same time, like heart disease with high blood pressure.

Inpatient: Staying in the hospital overnight.

Malignant: Describes cancerous cells that can grow and spread to other parts of the body.

Outpatient: Going to the hospital for treatment without staying overnight.

Prognosis: What’s likely to happen with an illness or condition over time.

Remission: When symptoms get better or go away.

10 health insurance terms made simple

Claim: A request made to your insurance company to pay for healthcare services.

Copayment: A set fee you pay each time you go to the doctor or get a medical service.

Deductible: The amount you need to pay for healthcare before your insurance starts to cover expenses.

Explanation of benefits (EOB): A statement showing what your insurance paid and what you owe.

Network: A group of doctors and facilities that your insurance plan prefers you to use.

Out-of-pocket maximum: The most you’ll pay for covered services in a year, after which the insurance covers 100%.

Percentage of the cost: Your share of healthcare costs — a percentage you pay after reaching your deductible.

Preexisting condition: A health issue you had before getting health insurance.

Preapproval: Approval from your insurer before you get a particular service or medication.

Referral: Approval from a primary care doctor to see a specialist.

Find more common health insurance terms.

Check out more resources that provide clear health and plan information

Get the most from your plan

Managing your health is easier when you can quickly find answers to healthcare and plan questions. We explain everything — from types of care to costs and more.

Have the tests you need

Know which medical tests you need to stay healthy and catch symptoms early.

Save money

Understand care options and benefits to help you avoid extra tests, unexpected bills, and hospital stays to lower costs.

Be ready for your doctor visits

Get tips on asking your doctor questions and making sure you understand the answers.

Still have questions?

Contact Member Services by calling the number on the back of your member ID card. You can also find a doctor by using the Find Care tool on the Sydney^SM Health app or at anthem.com.

Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of your health plan. © 2020-2025.

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