Resources & FAQ
Understanding Health Insurance Shouldn't Require a Degree.
Plain-language answers to real questions people ask about health insurance — so you can make informed decisions about your coverage.
Key Terms Explained
The most important health insurance terms — in plain English.
Premium
The monthly amount you pay for your health insurance plan — whether you use it or not.
Deductible
The amount you pay out of pocket for covered services before your insurance starts sharing costs.
Copay
A fixed amount you pay for a specific service, usually after your deductible is met.
Coinsurance
After your deductible is met, the percentage of costs you share with your insurer.
Out-of-Pocket Maximum
The most you'll pay for covered services in a plan year. Once you hit this limit, your insurance covers 100% of covered costs for the rest of the year.
Network
The group of doctors, hospitals, and providers that have agreed to provide services at negotiated rates for your plan.
PPO (Preferred Provider Organization)
A plan type that gives you more flexibility to see any doctor without a referral, including out-of-network providers at higher cost.
HMO (Health Maintenance Organization)
A plan type that requires you to choose a primary care physician and get referrals to see specialists. Generally lower premiums but less flexibility.
HDHP (High-Deductible Health Plan)
A plan with a higher deductible and lower premium. Often paired with a Health Savings Account (HSA).
HSA (Health Savings Account)
A tax-advantaged savings account available with HDHPs. Funds can be used for qualified medical expenses and roll over year to year.
ACA / Marketplace Coverage
Health insurance plans available through the federal or state Marketplace, regulated under the Affordable Care Act. Financial assistance may be available based on income.
Special Enrollment Period (SEP)
A window outside of Open Enrollment when you can sign up for or change health insurance due to a qualifying life event, such as losing employer coverage.
Frequently Asked Questions
Still Have Questions?
The best way to get clear answers is a direct conversation. I'm happy to walk through any of these topics as they apply to your specific situation.
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