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Health insurance is a contract between you and an insurance company that helps pay for medical expenses. You typically pay a monthly premium, and when you receive covered healthcare services, the insurer pays part of the cost according to your plan's rules. You may still be responsible for deductibles, copays, coinsurance, and services that are not covered.

Premium: The amount you pay regularly (usually monthly) to keep your insurance coverage active. Deductible: The amount you must pay for covered healthcare services before your insurance starts sharing costs. Copay (Copayment): A fixed amount you pay for a specific service, such as $25 for a doctor's visit. Coinsurance: Your share of the cost after you've met your deductible, usually expressed as a percentage (for example, you pay 20% and the insurer pays 80%).

The out-of-pocket maximum is the most you will pay for covered healthcare services during a plan year. Once you reach this limit through deductibles, copays, and coinsurance, your insurance generally pays 100% of covered in-network services for the rest of the year. Premiums usually do not count toward the out-of-pocket maximum.

Coverage varies by plan, but common covered services include: - Doctor visits - Hospital care - Emergency services - Laboratory tests - Mental health services - Maternity care - Prescription drugs - Preventive care Review your plan's Summary of Benefits and Coverage (SBC) or member handbook for specific details.

In-network providers: Have contracts with your insurance company and usually offer lower costs. Out-of-network providers: Do not have contracts with your insurer and often cost more. Some plans may not cover out-of-network care except in emergencies. Using in-network providers generally saves money.