What is health insurance?

It may seem like a simple question, but health insurance can be quite confusing. At its most basic, health insurance helps pay for the health services you need.

What terms do I need to know?

Premium: A payment due every month in order to remain enrolled in your insurance plan.

Co-pay: A small amount of money that you must pay at the time of your visit, once you have reached your deductible.

Deductible: The amount that you must pay for health care expenses before insurance covers the costs. For example if you have a $100 deductible, your insurance will start covering services after you show them that you have spent $100 on your health care.

Co-insurance: A proportion of medical service cost that you are responsible for paying, once you have reached your deductible.

Explanation of Benefits (EOB): The insurance company’s written explanation to a claim, showing what they paid and what you must pay.

Out-Of-Pocket Maximum: A predetermined, limited amount of money that an individual must pay before an insurance company (or self-insured employer) will pay 100% for an individual’s healthcare expenses.