Knowing This Terminology Will Help You Shop for Health Insurance

Posted on: 24 June 2021

Shopping around for health insurance is not exactly fun, in most cases. But it does not have to be confusing, either. One way to make shopping for health insurance easier is to review some important terminology beforehand. Understanding these terms will help you make more sense of what you read, which will enable you to compare plans more effectively.


With any type of insurance, a deductible is the amount that you have to pay, out of pocket, before your insurance will kick in. With health insurance, deductibles are typically annual. So, for instance, if a plan has a $2,000 annual deductible, you'll have to pay $2,000 towards your yearly health services before your insurance starts paying for additional claims.


A premium is the amount that you pay each month for your health insurance policy. If your premium is $300, you'll pay $300 a month to keep your health insurance active.


A copay is the amount that you have to pay, out of pocket, towards a particular health service. If your insurance play has a $20 copay for visits, that means you'll need to pay $20 each time you have a checkup. Your doctor and insurance will work out a deal to pay the rest.

Out-of-Pocket Maximum

An out-of-pocket maximum is the maximum amount that your insurance can expect you to pay, per year, out of your own pocket for health services. This includes your deductible and co-pays.


A POS plan, or point of service plan, is a type of health insurance plan. What sets this type of plan apart is the way you get treatment. You have a primary care doctor, and that doctor has to refer you to other practitioners if you end up needing more specialized care. You can only seek care from practitioners in your network, or else your insurance plan won't cover the cost.


A PPO plan is another type of health insurance plan. PPO stands for preferred provider organization. Under this kind of plan, you can visit a list of providers who are in-network with your insurance company. But you can also visit out-of-network providers without a referral from your primary care doctor — and your insurance will pay at least a portion of the bill.

Hopefully understanding these terms will make it easier for you to choose a good health insurance provider and plan. To learn more, contact health insurance companies.