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Cost-sharing

The portion of healthcare costs that individuals pay themselves, such as deductibles, copayments, and co-insurance, even when they have insurance.

Deductible

The amount of money an individual must pay for covered healthcare services before their insurance plan starts to pay.

Group health plan

A health insurance plan offered by an employer or other organization to its employees or members.

Individual health insurance coverage

Health insurance purchased directly by an individual from an insurance company, rather than through an employer or group.

Selected insulin products

Specific types and forms of insulin (e.g., rapid-acting, long-acting, vials, pumps) chosen by an insurance plan to be covered under certain cost-sharing rules.

Negotiated price

The discounted price for a medication or service that an insurance company or plan has agreed upon with a pharmacy or provider, after accounting for all rebates and concessions.

Out-of-pocket maximum

The most an individual has to pay for covered services in a plan year before their health insurance plan begins to pay 100% of the covered costs.