This guide explains the most common terms used to compare plans and avoid surprises.
Quick definitions
- Premium: what you pay each pay period
- Deductible: what you pay before the plan starts paying
- Copay: fixed cost for a visit (e.g., $30 primary care)
- Coinsurance: percentage you pay after deductible (e.g., 20%)
- Out-of-pocket max: the most you pay in a plan year for covered services
How to choose (simple approach)
- If you expect frequent care or ongoing prescriptions, compare out-of-pocket max and network coverage.
- If you expect minimal care, compare premium and deductible levels.
- If you are considering an HSA-eligible plan, confirm eligibility and contributions.
Note: HR can explain plan options and process, but cannot provide medical advice.
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