What is the difference between a copay and coinsurance?

A copay is a flat dollar fee per visit. Coinsurance is a percentage of the bill.

Do premiums count toward the deductible?

No. Premiums and deductibles are separate buckets, and premiums never reduce the deductible.

Your yearly spending on covered care. Premiums and out-of-network care sit outside the cap.

Not by itself. Low premiums plus an HSA can beat a richer plan in healthy, high-earning years.

Short answerFive numbers run every health plan: premium, deductible, copay, coinsurance, and out-of-pocket max. Learn those and any plan makes sense.

The premium is your monthly bill for having the plan. You pay it whether you see a doctor or not.

The deductible is what you pay first each year before the plan helps. After you meet it, cost-sharing starts.

A copay is a flat fee per visit. Coinsurance is your percentage of the bill after the deductible.

The out-of-pocket max is the yearly ceiling. Hit it and the plan pays 100% of covered care for the rest of the year.

Say your plan has a $2,000 deductible, 20% coinsurance, and a $6,000 out-of-pocket max. You face a $10,000 surgery bill.

You pay the first $2,000. Of the remaining $8,000, you pay 20%, which is $1,600. Your total is $3,600.

Premiums sit outside this math. They are the price of admission, paid every month.

A high-deductible plan trades lower premiums for a higher deductible. For 2026 the minimum deductible is $1,700 single or $3,400 family.

Pair it with a health savings account. The 2026 HSA limit is $4,400 single or $8,750 family, plus $1,000 at 55 and older.

HSA money goes in pre-tax, grows tax-free, and comes out tax-free for medical costs.