Co-payments, or co-pays are flat dollar amounts that are paid at the time of service. For example, you may have a $15 per office visit co-pay for doctor visits and a $25 per office visit co-pay for specialist visits.

Negotiated Amount is the contracted rate that a PPO plan has negotiated with its preferred providers. It is also called the Allowed Amount or Discounted Amount. This is the rate that the provider has agreed to accept for his/her services, and is the amount that the co-insurance percentage is based upon.

Co-insurance refers to the percentage of the covered expenses that the plan and you pay. For example, an 80 percent co-insurance means the plan will pay 80 percent of the fees; you will pay the remaining 20 percent. PPO plans typically will have higher co-insurance levels for in-network versus out-of-network services.

Deductibles in health care plans are similar to the deductibles on your car insurance. They are an amount that you must pay before the health plan will pay for any covered services. Generally, there are individual deductibles and family deductibles. The individual deductible applies to each individual's use of services; the family deductible is an aggregate amount and limits the amount of individual deductibles that must be paid before the plan will pay. Deductibles must be met every calendar year and once that is met, the co-insurance applies. The deductible rules are not the same for all health care plans. In most cases, co-payments are not counted towards the deductible limit.

Explanation of Benefits (EOB) is a form produced by the health plan every time there is a claim submitted. The EOB will show you the dollar amount of the claim submitted for payment and how much the plan paid for the claim. EOBs are typically used for PPO plans and may not be sent if you do not have any responsibility for any of the payment. EOBs also keep track of your deductibles.

Out-of-pocket maximum, also called the co-insurance limit, is typically used with PPO plans. This is the maximum amount of co-insurance you have to pay in a year before the plan pays 100% co-insurance. This amount does not include money paid towards the co-pays or deductibles.

Summary of Coverage (SOC) booklets are sometimes called Evidence of Coverage booklets or Summary Plan Description booklets. These booklets provide detailed descriptions of the benefits that are covered under the plan as well as other legal notices such as the plan's appeals process. They also may specify benefits that are not covered by the plan.