Health and life insurance glossary

Premium, deductible, copay and coinsurance

Premium: recurring payment to maintain insurance. Deductible: the amount you owe before the plan pays for certain services. Copay: a fixed amount for a covered service. Coinsurance: a percentage of a covered cost. Florida Blue explains these components; check when each applies to your plan.

Medical out-of-pocket maximum

The applicable limit on member expenses for covered in-network benefits during the plan year. It excludes premiums, uncovered services and generally out-of-network care. HealthCare.gov explains these differences; do not confuse it with a dental annual maximum.

Network and referral

Network: providers participating in a plan. Referral: an instruction some plans require to access certain specialists. HMO, PPO and EPO describe different structures; knowing the acronym does not replace reviewing your coverage rules.

Beneficiary and death benefit

A beneficiary is the person or entity designated to receive the benefit under a life policy. The death benefit is the payment specified after the insured person's death under its conditions. Verify names, percentages and required documents with the company.

Cash value and illustration

Some permanent policies include cash value. An illustration shows how a policy may work and should distinguish guarantees from projections. Ask for explanations using the document itself and how charges, payments or transactions could affect it.

For your next conversation

• Ask for an explanation of unfamiliar terms.
• Compare the same cost categories between plans.
• Identify limits and exceptions in the documents.
• Keep the policy and summary of benefits.

Sources and review date

Sources consulted September 26, 2026. Written by Febres 360°; check the official links for later changes.

• Florida Blue · How coverage works
• HealthCare.gov · Out-of-pocket maximum
• Oscar · HMO, PPO, EPO and POS