03/03/2026
We have many patients ask us about how their health insurance works. Thought I'd share the basics.
Key Health Insurance Terms to Know
Premium: The amount you pay every month just to have the plan, regardless of whether you use medical services.
Deductible: The amount you must pay for health services before your insurance plan begins to pay.
Copayment (Co-pay): A fixed amount (e.g., $40) you pay for a covered health service, usually at the time of the visit.
Coinsurance: Your share of the costs of a covered health care service, calculated as a percentage (e.g., 20%) of the allowed amount.
Out-of-Pocket Maximum: The most you could pay for covered services in a plan year; after this, the plan pays.
Network: The facilities, providers, and suppliers your health insurer has contracted with to provide health care services.
Here's a great explanation in infographic:
