Health plans use several forms of cost sharing. A deductible is generally the amount you pay for covered services before the plan begins paying according to its terms. A copay is typically a fixed dollar amount for a covered service, while coinsurance is generally a percentage of the allowed cost.
These features interact with the plan’s network rules, covered benefits and out-of-pocket maximum. A plan with a lower monthly premium can sometimes involve higher cost sharing when you receive care.
When comparing plans, consider both expected medical use and the financial impact of an unexpected high-cost year. Always review the official plan documents for definitions, exclusions and network information.
Educational information only. Insurance products, requirements and policy terms vary. Verify current details with the insurer, a licensed professional or your state regulator.