The plain-English glossary.

What you pay every month to keep the plan active.

What you pay for covered care each year before the plan starts sharing costs.

A flat fee for a service, like $30 for an office visit.

Your percentage of a bill after the deductible is met.

The most you'll pay for covered, in-network care in a year.

The doctors and hospitals that have agreed to the plan's prices.

A plan that usually keeps you in network and may require referrals to see specialists.

A plan that lets you see specialists without referrals and covers some out-of-network care.

In-network only, like an HMO, but usually without referrals.

A tax-advantaged savings account you can pair with an HSA-eligible plan.

The plan's list of covered prescription drugs and what tier each one is on.

A Marketplace discount on your monthly premium based on household income.

Extra savings on deductibles and copays for some Silver-plan enrollees, based on income.

The yearly window when anyone can sign up for or change an ACA plan.

A window to enroll outside Open Enrollment after a qualifying life event.

When an insurer reviews your health to decide whether to offer a plan and at what price.

An all-in-one alternative to Original Medicare, offered by private insurers (Part C).

A Medicare Supplement plan that helps pay the costs Original Medicare leaves behind.

Medicare prescription drug coverage.

An arrangement where an employer reimburses employees, tax-free, for individual health plans they choose.

A simple list of employees with ages and ZIP codes, used to quote group coverage.