Brace yourself for this – even with medical insurance, you’re still going to have costs to pay out of your own pocket. Here’s your cheat sheet. Look for these five terms to get an idea what you’ll be paying during a year with a given health plan.
Premium – What you pay (usually monthly) to have medical insurance.
Deductible – What you must pay for expenses covered by your health plan before the insurance company will pay.
Copay – A set dollar amount you have to pay to receive certain services, like $30 for a doctor office visit.
Coinsurance – The percentage you pay of covered medical expenses after you’ve met your deductible, often 20% to 30%. That means every $20 to $30 out of $100 is yours to cover even after you meet your deductible.
Out-of-pocket maximum (or out-of-pocket limit) – The most you pay during the term of the health plan toward covered expenses.
Generally speaking, premium payments and copays don’t count toward your deductible.