Health insurance can come with a lot of unfamiliar terms. Understanding a few of the basics can make it easier to know how your coverage works, what you may pay for care, and how to make the most of your benefits.

Here are five common health insurance terms worth knowing.

1. Deductible

Your deductible is the amount you generally pay for covered healthcare services before your health plan begins sharing certain costs.

For example, if your plan has a $2,000 deductible, you may be responsible for the first $2,000 of covered services that are subject to the deductible before the plan begins paying its share.

2. Copay

A copay is a fixed amount you pay for certain covered healthcare services.

For example, your plan might require a $30 copay for a primary care office visit. Some services with a copay may not require you to meet your deductible first, depending on your plan.

3. Coinsurance

Coinsurance is the percentage of a covered healthcare expense you pay after meeting your deductible.

If your plan has 20% coinsurance and a covered service has an allowed cost of $1,000, you would generally pay $200 and your health plan would pay $800.

4. Out-of-Pocket Maximum

Your out-of-pocket maximum is the most you’ll pay during the plan year for covered, in-network services that count toward the limit.

Once you reach that amount, your health plan generally pays 100% of covered, in-network benefits for the remainder of the plan year.

5. Provider Network

Your health plan’s provider network includes the doctors, hospitals and other healthcare providers that participate in your plan.

Before scheduling care, it’s a good idea to confirm that a provider is in your network. Receiving care outside your network may result in higher costs or, depending on your plan, may not be covered at all.

A Little Knowledge Can Go a Long Way

You don’t need to be a health insurance expert to make informed decisions about your care. Understanding these basic terms can help you better anticipate costs, compare your options and get more from your health insurance.

And remember, every health plan is different. Review your plan documents for details about your specific coverage, or reach out if you have questions.

Have Questions About Your Coverage?

Health insurance can be confusing, and you don’t have to figure everything out on your own. Professional Insurance Programs is here to help you better understand your coverage and answer your health insurance questions.