Health Insurance Terms
open enrollment period - Also known as annual enrollment period, the specific time each year that you can buy a health insurance plan, renew the plan you already have, or switch to another plan.
out-of-network providers - The doctors, hospitals, labs, and other health care providers who DO NOT have a contract with a health insurance company. Some health plans include coverage (at a higher cost) for out-of-network providers, and some may not provide coverage at all.
out-of-pocket costs - Also known as cost-sharing, it’s the amount of money you pay for care, in the form of copays, deductibles, and coinsurance. This is in addition to the premium or monthly rate you pay to be a member of the health plan.
out-of-pocket maximum - This is the maximum amount that you will have to pay for care during the plan year. This does not include your premium, just out-of-pocket costs, such as copays, deductibles, and coinsurance. Any care you receive after you meet your out-of-pocket maximum is covered 100 percent. For example, if your out-of-pocket maximum is $6,000 and you reach this amount, your health plan will cover any additional costs for covered services in full (some exclusions may apply; see your benefits for details).