Insurance Terminology Explained

Cost Terms

• Premium — the amount paid for coverage, usually monthly
• Deductible — what you pay before certain benefits apply
• Copay — a fixed amount for a covered service
• Coinsurance — a percentage share of a covered service
• Out-of-pocket maximum — the most you pay for covered services in a plan year

Access Terms

• Network — providers contracted with the plan
• Formulary — the plan's list of covered prescriptions
• Prior authorization — approval required before certain services
• Referral — approval to see a specialist under some plan types

How a Coverage Review Works

A licensed advisor reviews your household details, location, budget range, preferred doctors, prescriptions, and coverage priorities. Available options are then explained side by side so the differences are easy to understand.

Nothing is submitted until you decide how you would like to move forward. Plan availability, networks, pricing, and eligibility vary by state and applicant.

• Discuss your situation and coverage goals
• Compare available option types in plain language
• Review costs, networks, and prescription considerations
• Receive guidance through the next steps when you are ready