Glossaries
Health Insurance
Glossaries
Health Insurance
Coinsurance
The amount (a percentage) that you pay for medical care after you have met the deductible.
Copay
A fee you pay each time you get medical care.
Deductible
The amount you pay completely out of pocket before your insurance starts to cover any of the cost.
Exclusions
Events, conditions, and activities for which your insurance will not cover you.
HMO (Health Maintenance Organization)
Insurance plans can be HMOs or PPOs. HMO plans are usually cheaper, but they limit which doctors you can visit. If you visit a doctor or specialist outside your network, your care might not be covered by insurance.
Network
The doctors and other medical providers contracted to provide care to people with a specific insurance plan.
PPO (Preferred Provider Organization)
Insurance plans can be HMOs or PPOs. PPO plans usually have a higher premium, but allow patients more freedom when choosing a medical provider.
Premium
The amount you pay every month/year for your insurance, regardless of whether you need medical care.
Total out-of-pocket maximum
The maximum you will spend in any year of coverage (including deductible, copay, and coinsurance).