It’s hard to make the most of your health plan if you aren’t sure what all of the health terms mean.

If your plan has one or more of these, here is what it means for you:

Copayment (or copay)
This is the amount you will pay to a provider (your doctor or hospital) at the time of service. For an office visit, copays are typically between $5–$50. Keep in mind that money spent on copays will not count towards your deductible.


Deductible
This is the total amount you will pay for covered services (such as nonpreventive office visits, lab tests, and other items) before your health plan pays some or all of the bill. Only covered services count towards the deductible.

For example, if your plan has a $1,000 deductible, you will pay the first thousand dollars of bills from your provider (your doctor, lab, or hospital). After you reach your deductible, you will not have to pay any more money for most covered services for the rest of your plan year. Your health plan will pay those bills. You may still have to pay copays or coinsurance.

You may not have to pay for preventive care and screenings, such as check-ups and mammograms. Check your Evidence of Coverage or Benefit Document to see what your health plan pays for and what counts toward your deductible.


Coinsurance
This means you will be sharing the responsibility of paying for a service (like an office visit, procedure, or admission) with your health plan. Usually coinsurance is listed as a percentage.

For example, say your plan has 20% coinsurance and your doctor charges $100 to perform a procedure. You would pay $20 to the doctor and your plan would pay the other $80. Sometimes coinsurance only applies after you have met your deductible.