Deductibles, coinsurance and the out-of-pocket maximum

Your premium is only part of what health care costs you. Four other numbers decide what you pay when you use care.

The key terms

• Premium: what you pay each month to have the plan
• Deductible: what you pay for covered care before the plan starts sharing costs
• Copay and coinsurance: your share after the deductible, a fixed amount or a percentage
• Out-of-pocket maximum: the most you pay for covered, in-network care in a plan year; after that, the plan pays 100%

Good to know

• Premiums don't count toward the deductible or out-of-pocket maximum
• Some services, like preventive care, may be covered before the deductible
• Out-of-network care may not count, or may have separate limits

General educational information, not medical or insurance advice. Dime and Dollar isn't paid by any insurer, provider, pharmacy or discount program.