Insurance Terms Explained
A plain-language glossary to help you read insurance materials and compare options with more confidence.
Core vocabulary
- Premium
- The amount paid to keep a policy active.
- Policy
- The contract that describes coverage and conditions.
- Claim
- A request for benefits.
- Deductible
- An amount a member may pay before certain plan benefits begin.
- Coverage
- The services, events or losses addressed by a contract.
More terms
Definitions and use can differ across insurance products.
- Limits
- The maximum a policy may pay for a covered benefit or period.
- Exclusions
- Services, events or conditions the policy does not cover.
- Riders or endorsements
- Additions that change or add to a policy’s terms.
- Provider network
- The doctors, hospitals and other providers that participate with a plan.
- Copayment
- A set amount a member may pay for a particular service.
- Coinsurance
- A percentage of the cost a member may share with the plan.
- Out-of-pocket maximum
- A limit on what a member may pay for covered services in a plan year, where the plan includes one.
Comparing options
A useful comparison looks beyond the monthly price. Consider deductibles, limits, exclusions, networks, covered services and eligibility.
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