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Health Insurance: Basic Terms to Know


Premium refers to the amount of money you pay for your health insurance. If your insurance is provided by your employer, the premium is split between you and your employer. If you pay for your own insurance, you pay 100% of your premium or you can have it subsidized through the Affordable Care Act. 


A deductible is an amount you need to pay before your insurance company begins to cover any expenses. You can usually choose the deductible amount when you buy insurance.

Out-of-pocket maximums

This is the most a policyholder would have to share in health care costs on an annual basis.

Health savings account (HSA)

This saving account allows you to save money pre-tax dollars which you can spend on qualified medical expenses.

The “Affordable Care Act” (ACA) is the name for the comprehensive health care reform law and its amendments. The law addresses health insurance coverage, health care costs, and preventive care. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010.

  • Platinum: covers 90% on average of your medical costs; you pay 10%
  • Gold: covers 80% on average of your medical costs; you pay 20%
  • Silver: covers 70% on average of your medical costs; you pay 30%
  • Bronze: covers 60% on average of your medical costs; you pay 40%
  • Catastrophic: Catastrophic policies pay after you have reached a very high deductible ($8,150 in 2020).  Catastrophic plans must also cover the first three primary care visits and preventive care for free, even if you have not yet met your deductible.

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