Health Insurance glossary
Plain-language definitions of common health insurance terms.
- Coinsurance
- The percentage of a covered cost you pay after meeting your deductible — common in health policies (e.g., "insurer pays 80%, you pay 20%").
- Full definition of Coinsurance
- Copay
- A fixed dollar amount you pay for a covered service — common in health insurance ("$30 office visit").
- Full definition of Copay
- Deductible
- The amount you pay out of pocket on a covered claim before your insurance starts paying.
- Full definition of Deductible
- Network
- The group of doctors, hospitals, and other providers that have contracted with a health plan to deliver care at negotiated rates. Care from in-network providers usually costs you less.
- Full definition of Network
- Open enrollment
- Open enrollment is the yearly period when you can sign up for health insurance or change plans. Outside it, you generally need a qualifying life event, such as losing other coverage, moving, or having a baby, to enroll during a special enrollment period. Dates differ for Marketplace, Medicare, and employer plans.
- Full definition of Open enrollment
- Out-of-pocket maximum
- The most you have to pay for covered services in a plan year. After you reach it, the plan pays 100% of covered in-network costs for the rest of the year.
- Full definition of Out-of-pocket maximum