Health Insurance Glossary
Speak the language. Our complete glossary defines health insurance terms so you can understand the industry's vocabulary.
Every key term
Money terms
Plain English
Speak the language. Our complete glossary defines health insurance terms so you can understand the industry's vocabulary.
Premium: your monthly cost. Deductible: what you pay before the plan shares costs. Copay: flat fee per service. Coinsurance: your percentage share after the deductible. Out-of-pocket maximum: your annual worst case.
Network: the doctors and facilities under contract with your plan. Referral: permission from a primary doctor to see a specialist, required by some plan types. Prior authorization: plan approval needed before certain services.
Open enrollment: the annual signup window. Special enrollment period: a 60-day window triggered by life events. Qualifying life event: a change like job loss, marriage, or a birth that unlocks that window.
Metal tiers: bronze, silver, gold, platinum, which describe cost sharing, not quality. Premium tax credit: the income-based subsidy that lowers monthly cost. Formulary: a plan's covered drug list.
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