Health insurance glossary

Jump to: A B C D F H O P S W

A

Affordability test

Rule that job coverage is affordable if employee-only premiums are under a set share of income. 2027.

B

Benchmark plan

The second-lowest-cost silver plan in your area; the tax credit is based on its price.

C

Catch-up contribution

Extra $1,000 HSA contribution allowed from age 55.

COBRA

Federal law letting you keep job-based coverage after leaving, at up to 102% of cost. COBRA FAQ.

Coinsurance

Your percentage share of costs after the deductible, such as 20%.

Copay

A fixed amount for a service, such as $30 per visit.

Cost-sharing reductions

Extra savings on deductibles and copays for silver marketplace plans at lower incomes.

D

Deductible

What you pay for covered care each year before the plan starts sharing costs.

F

FPL

Federal poverty level, set yearly by HHS. Table.

FSA

Flexible spending account through an employer; mostly use-it-or-lose-it. HSA vs FSA.

H

HDHP

High-deductible health plan that meets IRS rules so you can contribute to an HSA. 2027 limits.

HRA

Health reimbursement arrangement funded only by the employer.

HSA

Health savings account: tax-free money for medical costs that rolls over and can be invested.

O

Out-of-pocket maximum

The most you pay for covered in-network care in a year; after that the plan pays 100%.

P

PPO

Preferred provider organization plan; usually lower deductible and covers some out-of-network care.

Premium tax credit

Federal credit that lowers marketplace premiums based on income. 2027 table.

S

Special enrollment period

A window outside open enrollment, usually 60 days after a qualifying life event, to sign up for coverage.

W

W-2 code DD

Box 12 code on your W-2 showing the total cost of employer health coverage.