The amount you pay every month for your health insurance, whether you use medical services or not.
The amount you pay out of pocket each year before your insurance starts to cover eligible costs.
A fixed dollar amount (e.g., $25) you pay for specific services like doctor visits or prescriptions.
The percentage of costs you pay after meeting your deductible (e.g., you pay 20%, insurance pays 80%).
The most you’ll have to pay in one year for covered services. After you reach this limit, your plan pays 100%.
A plan that usually requires you to use doctors and hospitals within a specific network and get referrals for specialists.
A plan that allows you to see both in- and out-of-network providers without referrals, but out-of-network care costs more.
A set time each year when you can enroll in, change, or cancel your health insurance plan.
A time outside of open enrollment when you can sign up for health insurance due to a Qualifying Life Event (QLE).
A major life change—like losing a job, getting married, or having a baby—that lets you enroll mid-year.
Financial help from the government to lower the cost of monthly premiums or out-of-pocket expenses.
A group of doctors, hospitals, and other healthcare providers that your insurance plan has agreed to work with.
A list of prescription drugs your plan covers, including which tier each drug falls under for pricing.
A tax-advantaged savings account for people with high-deductible plans, used to pay for medical expenses.
When a provider charges you the difference between their fee and what your insurance pays (usually out-of-network).
A document from your insurer explaining what services were covered and what you might owe after a claim.
A federal law that protects your personal health information and how it can be shared or accessed.
