These four terms describe what you pay and when. A deductible is the amount you pay yourself before the plan starts sharing most costs. A copay is a flat fee for a specific service, such as thirty dollars for an office visit, and some copays apply even before you meet your deductible. Coinsurance is a percentage of the bill you pay after the deductible is met, for example twenty percent while the plan pays eighty percent.

The out-of-pocket maximum is the safety net. It is the most you will pay in a plan year for covered, in-network services. Once your deductible, copays, and coinsurance add up to that limit, the plan pays 100 percent of covered services for the rest of the year. Premiums do not count toward this limit.

When we compare plans, we look at all of these numbers together, not just the premium. A plan with a low monthly cost but a very high deductible can cost you more overall if you use care regularly, while a slightly higher premium with a lower deductible may be the better value for your situation.