Plan Basics

Plain-English definitions of common health insurance terms, from deductible and coinsurance to premium tax credit, COBRA and Medigap, grouped by topic.

Family plans usually have a deductible for each person and one for the whole family. How embedded and non-embedded deductibles work, with an example.

A POS plan works like an HMO with some out-of-network coverage: you use a primary care doctor and referrals, and pay more to go outside the…

An FSA lets you set aside pre-tax pay through your job for medical costs. The 2026 limit is $3,400, and unused money is usually lost. How…

The ACA’s 10 essential health benefits are the kinds of care individual and small-group plans must cover, from ER visits to prescriptions. Here’s what’s left out.

Prior authorization means your plan must approve care before it pays. How long it takes, why requests get denied, and how to get approved faster.

An EPO covers care only from in-network doctors and hospitals, except emergencies, and usually skips referrals. How EPOs compare with HMOs and PPOs.

Want a health insurance quote without giving your name or SSN? ACA prices depend on ZIP, ages and income, so anonymous tools can be accurate. Where…

The out-of-pocket maximum is the most you’ll pay for covered in-network care in a year. What counts toward it and the 2026 and 2027 limits.

A copay is a flat fee for a covered service. How copays work, how they differ from deductibles and coinsurance, and when you owe nothing at…