Health insurance terms, explained simply
Every health insurance term — decoded. New? Start here →
Term of the Day
Step Therapy
An insurer's requirement to try lower-cost medications before approving a more expensive drug.
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Insurance Basics
Understand the foundational concepts behind how health insurance works — from premiums and deductibles to your annual out-of-pocket limit.
Plan Types
Compare different plan structures — HMO, PPO, EPO, POS, and HDHP — to understand tradeoffs between cost and provider flexibility.
HSA & FSA
Learn how tax-advantaged accounts like Health Savings Accounts and Flexible Spending Accounts can reduce your healthcare costs.
Medicare & Medicaid
Navigate federal health programs — Medicare for seniors and people with disabilities, Medicaid and CHIP for lower-income individuals and families.
Programs & Law
Understand major healthcare laws and programs — the ACA marketplace, COBRA continuation coverage, and HIPAA privacy rights.
Billing & Claims
Decode your medical bills and insurance paperwork — prior authorizations, formularies, and how to read an Explanation of Benefits.
Visitor Coverage Insurance
Health insurance for non-US residents visiting the US, or US citizens returning from abroad. Covers plan types, key terms, visa requirements, and what to watch out for.
Common Terms
The terms everyone encounters first.
Deductible
The amount you pay out-of-pocket before your insurance starts covering costs.
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Premium
The monthly amount you pay to keep your health insurance coverage active.
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Copay
A fixed amount you pay for a specific covered service at the time of care.
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Out-of-Pocket Maximum
The most you'll ever pay in a plan year for covered services.
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HMO (Health Maintenance Organization)
A plan that requires you to use a specific network of doctors and get referrals for specialists.
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PPO (Preferred Provider Organization)
A flexible plan that lets you see any doctor without a referral, with lower costs in-network.
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