Terms

Coinsurance: The percentage of costs you pay after your deductible is met. Generally, this is a percentage split by you and your insurance provider; 80/20 splits are common and mean that you are responsible for 20% of costs after the deductible.

Copay: Often confused with coinsurance, a co-pay is a fixed amount of money that your insurance plan requires you pay towards a specific medical cost. A common example of a co-pay is the small flat fee you pay each time you visit a doctor or emergency room.

Deductible: A fixed amount that you are expected to pay before your coinsurance will apply. Once you have paid an amount equal to your total deductible for the policy year, your coinsurance will then apply. After you meet the deductible, your insurance plan covers all or part of your expenses until year's end. 

Premium: What you pay, usually monthly, for your insurance plan. This is a bill and is unrelated to other out-of-pocket expenses you are expected to pay.

Out-of-Pocket Payments/Max: The direct payment of money from your own “pocket” that may or may not be later reimbursed from a third-party source.

Network: A group of providers that contractually partner with your insurance carrier. Your insurance plan will incentivize you to choose from this network by charging you less for treatment by these providers.

Contracted Rate: A discount you get by seeing a contracted provider with your insurance. That is the rate that would go towards your deductible/coinsurance calculations. Thus, you would only have to pay a discounted amount when you see a provider, even if the actual cost of service is higher. For example, if the total cost of a health service is $500, you might only actually have to pay $250, which would go towards your deductible, while the remaining $250 would be adjusted away by the insurance company.