Top 5 Need-to-Know Health Plan Terms


Along the path to choosing a health plan that meets your needs, you will encounter many insurance terms and phrases, and it’s to know what each one means. At GuideStone®, our goal is to equip you with the information you need to make the best decisions for you and your family.

Here are the top 5 terms you need to know:


A deductible is the amount you pay out-of-pocket before co-insurance takes effect and is often the associated number with your plan. If your deductible is $1,000, that means you need to pay $1,000 on health care services before the plan starts covering the co-insurance percentage for the rest of the year. The lower the deductible, the faster you get covered at the co-insurance level.


After you meet your deductible, co-insurance is the split between what you and your health plan pay for eligible claim expenses. For example, if your plan has 80/20 co-insurance, that means the plan pays 80% of the claim, and you pay 20%.

Preventive Care

Preventive care includes routine procedures such as check-ups, screenings and immunizations. Every GuideStone plan covers 100% of preventive care. This means these services are at no cost to you! Taking care of yourself today can help your quality of life later.


While some services like preventive care are 100% covered, other services have co-pays. A co-pay is the fixed amount you pay onsite for certain in-network expenses like a primary care visit or urgent care.

Maximum Out-of-Pocket (MOOP)

The maximum out-of-pocket, or MOOP, is the absolute maximum you will pay under a plan, including your deductible, co-pays and prescription costs. Once you reach this limit, the plan pays 100% of your claims.

GuideStone is here to help equip you and your ministry for Christ-centered well-being. We know that can be a complex task, but our team is always here to guide you through these discussions. Visit or call us Monday through Friday, from 7 a.m. to 6 p.m. Central Time.

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