Health Insurance basics

Health insurance has its own vocabulary, and the words decide how much you pay. Start with the four cost terms.

Your premium is what you pay each month to have coverage. Your deductible is what you pay for care before the plan starts sharing costs. A copay is a flat fee for a visit or prescription. Coinsurance is your percentage share of a cost after you meet the deductible.

Plans also have an out-of-pocket maximum — once you hit it, the plan pays 100% of covered, in-network care for the rest of the year.

Where you get a plan matters too: through an employer, the marketplace, Medicare (65+ or certain disabilities), or Medicaid (income-based). Each has different enrollment rules and timing.