The time to sign-up for your 2026 Schwab Insurance Medicare plan is October 15–December 7.

Common Insurance Terms FAQ

What is Coinsurance?

Coinsurance is a percentage of the cost for a covered service that you are responsible for paying after you’ve met your deductible. For example, if your coinsurance is 20%, you pay 20% of the cost of the service.

copay, or copayment, is a fixed amount you pay for a medical service or supply. Unlike coinsurance, it’s a set dollar amount (e.g., $10) rather than a percentage, and you typically pay it at the time of service.

deductible is the amount of money you must pay out-of-pocket for healthcare services before your insurance plan pays.

formulary, also known as a drug list, is a list of prescription drugs that are covered by your insurance or prescription drug plan.

In-network refers to doctors, hospitals, and other healthcare providers that have a contract with your insurance company. Using these providers typically results in lower costs for you.

The Maximum Out-of-Pocket (MOOP) is the annual limit on what you’ll have to pay for covered services. Once you reach this limit, you will not owe cost-sharing for Part A or Part B covered services for the remainder of the year. Some plans may also apply the MOOP to supplemental benefits such as vision, hearing, or dental.

medical deductible is the amount you pay for your medical care before your insurance plan starts to help cover the costs. Not all plans have this deductible.

Out-of-network refers to doctors and hospitals that do not have a contract with your insurance company. If you see an out-of-network provider, you may pay more out-of-pocket.

Out-of-pocket costs are the expenses you must pay for a portion of the services or drugs you receive. This includes things like deductibles, copays, and coinsurance.

Part D deductible is the amount you must pay for prescription drugs before your Medicare Part D plan starts to help with the costs. Not all plans have this deductible.

 

premium is the periodic payment you make to Medicare, an insurance company, or a healthcare plan to maintain your health or prescription drug coverage.

referral is a written order from your primary care doctor that allows you to see a specialist or get specific medical services. Many plans, like HMOs, require a referral for you to see any provider other than your primary care doctor. You do not need a referral with Schwab Health HMO and PPO plans.

Tiers are groups of drugs within a formulary that have different costs. Generally, drugs in a lower tier are less expensive for you than drugs in a higher tier.