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Health insurance terms you should know

Open enrollment is here, and you have a chance to adjust your healthcare plan. But truth be told – it could be tough to choose the best coverage if you do not understand the difference between a premium and a copayment. Read below to get familiar with common healthcare terms that you will want to know before picking another plan.

Premium Your premium is what you will pay the insurance company for the privilege of having an active insurance plan. Most people pay theirs every month, but your payments might be due once a quarter or once a year. If you are eligible for a marketplace plan, there are tax credits available to offset the costs of health insurance premiums.

Copayment Also commonly referred to as copay, a co-payment is a fixed amount that you pay in addition to your premium for covered healthcare services. The amount of your copay can vary depending on the type of healthcare service.

Out-of-pocket maximum Is the maximum amount of money you will pay for covered services during a benefit period. The out-of-pocket maximum never includes your premium, balance-billed charges, or services your health insurance plan does not cover. The out-of-pocket maximum will vary from plan to plan but can include co-payments, deductibles, and co-insurance.

Deductible Is the amount you owe for covered healthcare services before your health insurance plan will begin to pay. For example, let us say you need a covered procedure that costs $4,000. Your deductible is $2,000. In this scenario, your health insurance plan will not pay anything until you have met your $2,000 deductible for this covered procedure. Keep in mind: The deductible may not apply to all services.

We can help you understand common health insurance terms and evaluate your health insurance options. We can help you find coverage, even if your best option in or out the affordable care act. Call us 866-508-0003 or write us at

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