Premium: The amount the policy holder pays to the health insurance carrier plan each month.

Deductible: The out-of-pocket amount the policy holder must pay before the health plan pays its portion.

Copayment: The dollar amount the policy holder must pay for a doctor office visit or service, such as for a prescription medication.

Coinsurance: After a deductible is met, some policies pay 100% while other pay a percentage. For example the term 80/20 refers to co-insurance. The carrier pays 80% while the insured pays 20%. Traditionally this is after a deductible is met. For example, after a $1000 deductible the plan may have 80/20 coinsurance. This is usually followed by an Out-of-Pocket Max, which is the maximum dollar amount the insured could pay for the calendar year. Example: After the $1000 deductible one pays 80/20 coinsurance for $2000. In this situation the most the health insurance subscriber could ever pay is $1000 plus the $2000 coinsurance, so $3000. $3000 would be the maximum-out-of-pocket.

Exclusions: Not all services are covered. The insured is expected to pay the entire cost of non-covered services. Example, most health insurance policies won't cover elective surgery such as plastic surgery, breast implants, infertility treatments etc.

Coverage limits: Most health policies only pay for medical costs until a certain dollar amount is reached. This may apply to individual services such as chiropractic coverage, transplants, etc. Or it can apply to the entire plan. A health insurance subscriber may be covered for a set amount like $3,000,000. This can be referred to as a lifetime maximum.

In-Network Provider: A provider is In-Network if he or she is contracted with the insurance carrier and agrees to offer benefits on the carriers behalf. Out-of-network providers are doctors who do not accept insurance. These doctors can be visited by the insured but the insured usually does not get the full benefits associated with ones policy.