Premium
The amount you pay each month to keep your coverage active.
Deductible
What you pay out of pocket before your plan starts sharing costs.
Copay
A fixed amount you pay for a covered service, like a doctor visit.
Coinsurance
The percentage of a covered cost you pay after meeting your deductible.
Out-of-pocket maximum
The most you’ll pay in a year before your plan covers 100% of covered care.
PPO network
A group of doctors and hospitals your plan has agreed rates with. Broad PPOs give you more choice.
Open enrollment
The yearly window to enroll in or change an ACA/Marketplace plan.
Qualifying life event
A change like losing coverage that opens a special enrollment period.
