The words,
without the wordiness.
Eight useful starting points for a health coverage conversation.
Premium
The recurring amount you pay to keep health insurance active, whether or not you use care that month.
Deductible
The amount you pay for certain covered services before the plan starts sharing those costs. Plans may cover some services before you meet it.
Copayment
A set dollar amount you pay for a covered service. Check the plan documents for when it applies.
Coinsurance
A percentage of covered costs that you pay under the plan’s rules, rather than a fixed copayment.
Out-of-pocket maximum
A limit on your spending for covered in-network benefits in a plan year. Premiums and some other costs do not count toward it.
Provider network
The doctors, facilities and other providers contracted with a plan. Check the exact network for a plan you are considering.
Premium tax credit
Financial assistance that eligible Marketplace households can use to reduce their insurance premium. Eligibility depends on official application information.
Summary of Benefits and Coverage
A standardized summary for comparing covered benefits and important plan costs. It works alongside the fuller plan documents.