Health Insurance Glossary
Last updated: March 2026
Quick definitions for common health plan terms used in cost comparisons.
Use this page to clarify terminology while modeling plan options and annual costs.
Deductible
The amount of medical bills you need to pay in a year before insurance starts splitting the bills with you.
Coinsurance %
After you reach your deductible, this is the percent of each bill you pay while insurance pays the remainder.
Out-of-pocket max
The most you pay for covered medical bills in a year. After this, insurance pays 100% of covered costs.
HSA
Typically paired with high-deductible plans. Contributions are pre-tax, roll over yearly, and can be invested.
Copay
A fixed dollar amount you pay for certain services (like office visits or prescriptions). Copay plans often have higher premiums but lower costs for routine care. Copays usually do not count toward your deductible, but they typically count toward your out-of-pocket maximum.
Network type
HMOs often need referrals and in-network care. EPOs stay in-network without referrals. PPOs allow broader access.
In-network vs. out-of-network
In-network providers have negotiated rates. Out-of-network services are usually much more expensive.
Preventive care
Most plans cover preventive care at no extra cost when you use in-network providers.