Insurance terms in plain language

10 results

ACA (Affordable Care Act)

Federal healthcare law that established marketplace enrollment, plan standards, and subsidy structures for eligible individuals and families.

Deductible

The amount you pay for covered services before your plan begins sharing eligible costs.

Copay

A fixed dollar amount paid for certain services such as office visits or prescriptions.

Coinsurance

The percentage share of costs you pay for covered services after meeting your deductible.

Out-of-Pocket Maximum

The annual cap on your covered medical spending. After this limit, the plan typically pays 100 percent of covered in-network costs.

Special Enrollment Period

A time window outside open enrollment when eligible life events allow health plan enrollment changes.

Premium

The regular payment required to keep an insurance policy active, usually monthly.

Term Life Insurance

Life coverage active for a specific duration such as 10, 20, or 30 years, typically with lower initial cost than permanent policies.

Provider Network

The doctors, hospitals, and facilities contracted with a carrier at negotiated rates.

Explanation of Benefits (EOB)

A statement from your insurer showing how a claim was processed and your member responsibility amount.