Important: This site provides general education and does not enroll users in health plans.
Key health insurance terms
PremiumThe amount paid to keep coverage active.
DeductibleAn amount you may pay for covered services before the plan pays according to its terms.
Out-of-Pocket MaximumA plan-defined limit on certain covered in-network cost sharing during a plan year.
Copays and coinsurance
A copay is generally a fixed amount for a covered service. Coinsurance is generally a percentage of the allowed cost. Plan documents determine when each applies.
Provider networks
Networks can affect both access and cost. Before choosing a plan, check whether important doctors, hospitals and medications are covered under the plan’s current rules and formulary.
How to compare plans
- Look beyond the monthly premium.
- Compare deductibles and out-of-pocket limits.
- Check network participation for providers you use.
- Review prescription-drug coverage.
- Consider expected care as well as the risk of an unexpected high-cost year.
Understand Total Cost
A lower premium does not automatically mean a lower overall annual cost.
Cost-Sharing GuideBenefits, networks, eligibility and enrollment rules vary by plan and program. Confirm current details through official plan materials or a licensed professional.