TERMINOLOGY
Learn the Lingo
Some basic Definitions and Examples to help you understand how your policy works
Let's say your insurance agent, Mr. Girard, comes to you and says: "I found this fantastic plan that I think will meet your needs!  As long as you stay in-network, it has unlimited office co-pays of just $20, a $1500 deductible, then a 75/25 co-insurance split with an out of pocket max of $4500 which includes your deductible. It has a seperate $500 Rx deductible with $30 co-pays for brand name drugs and the monthly premium is just $300!  How does that sound?"

If that does not make sense, then watch the video and take time to educate yourself by learning the lingo.
co-pay = a specified dollar amount that an individual pays for health-care services at the time the service is rendered.
Example:  You could have an insurance plan where each visit to a doctor's office has a $30 co-pay.  This means that you will go to the doctor and pay just $30 for that office visit, even though he may normally charge $100 or more. [Tests or treatments may cost extra which you will be responsible for paying in full.]

co-insurance = a certain percentage that an individual pays for health-care services covered by his/her insurance plan.
Example:  You acquire a health insurance plan where the bills are split 70/30 between the insurance company and you after you have paid the full amount of the deductible.  The insurance company pays 70% and you pay the remaining 30%.  That remaining portion is the co-insurance.

covered services = anything and everything that your insurance company is willing to pay for, usually that which is deemed medically necessary.  There can be quite a few exclusions so read your policy carefully.
Example:  You are in an accident which results in a broken nose; therefore, your health insurance may help cover the expenses involved with doctors visits, time in a hospital, plus reconstructive surgery.  But if you think your nose is too big, therefore you want to have plastic surgery, the consultation and all expenses to "fix" your nose will most likely not be covered/paid by the insurance company.

deductible = the amount that an individual must pay out of his/her own pocket before the insurance company will begin to pay.   Deductibles are often "waived" for office visit co-pays.  Sometimes there is a seperate deductible for prescriptions.
Example:  Your health insurance plan has an annual deductible of $1000. This means you will pay the first $1000 of medical bills each year; however, if the plan has seperate co-pays for doctor's office visits, then you pay the co-pay instead of the cost normally charged for the office visit even if you have not yet reached your deductible for the year.  You will still be responsible for the full cost of tests or other services until you reach that deductible.

effective date = the specific date that your policy becomes active and ready for use.
Example:    Let's say you apply for coverage on November 12.  You finish the application and provide your credit card information.   Even if your application has been received, even if your payment is accepted that same day or a few days or even a few weeks later, the effective date is the official start date of your insurance coverage.   If the effective date is December 1st or January 1st (it is often the first day of an upcoming month) then do not expect the insurance company to be involved in any way with any of your medical bills until your policy is active on or after that effective date.   Pay close attention when applying for coverage.  You choose the month or date. 

in-network = doctors and hospitals who have already agreed to accept payment from specific plans from a particular insurance company. These healthcare providers in various cities and states form a group called a network, typically providing discounted service.
Example:  You purchase insurance from XYZ Insurance Company and are told that you will pay a certain amount for your care as long as you go to in-network providers.  (You will pay more if you go to out-of-network providers.)  Therefore you can call the company or go online for a list of in-network providers in your area, or you can call around and ask "Do you take XYZ insurance?"  If "Yes" then ask if they also accept, or will be accepting, the specific plan you want to use.

off exchange = health insurance that is paid by the consumer without any government subsidies
Example:   Henry is not low income and/or does not want his income to be a factor when acquiring a health insurance plan, so he compares plans and prices and buys health insurance by paying the cost himself.  (With the help of an agent, or perhaps here at InsureMyParts.com)

on exchange = health insurance that is partially or completely paid with government subsidies
Example:   Wilma is low income and/or suspects she can not afford to buy health insurance.   She visits 
healthcare.gov , answers questions about herself and total household income, then discovers that she qualifies for government assistance.  She is given a choice of plans and lower prices to choose from.   As long as her projected household income does not increase, the cost will stay the same.   If household income does increase, then she may be required to pay back some of the subidies she has received.  

out-of-network = all doctors and hospitals who are not part of a particular insurance company's network of healthcare providers.
Example:  You have open-heart surgery at Cardiologists-R-US but they do not accept your insurance from XYZ Insurance Co.; therefore, you will have to pay the big bill and file paperwork with XYZ for partial reimbursement. XYZ will pay you less than they would have paid an in-network provider, thus you will pay more for the privilege of receiving care outside your insurance network.

out of pocket max = the total amount of money an individual must pay out of his/her own pocket for covered services. (Annually)
Example:   Lets say you have health problems and require an organ transplant. All services are covered and the total bill is $150,000. If your out of pocket max is $6000, then the insurance company pays $144,000.  Any additional covered services (that policy year) are paid 100% by the insurance company because you are already maxed out.

policy = the paperwork given to you from an insurance company outlining specific details of your paid coverage.
Example:  A 10-page booklet of details regarding which services the insurance company will and will not pay, the effective date (when coverage first began), the premium you must pay, etc..  Often comes with a proof-of-insurance card to carry with you to the doctor that has your specific policy number on it.

premium = the amount you must pay to keep your policy active; it can be paid monthly, quarterly, semi-annually, or annually.
Example:  If you pay $300 per month for your health insurance, then you have a monthly premium of $300.