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Cost-sharing

The portion of healthcare costs that individuals pay out of their own pocket, such as deductibles, copayments, and coinsurance.

Deductible

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

Coinsurance

A percentage of the cost of a covered healthcare service that an individual pays after they've met their deductible.

Net Price

The actual cost of a drug after all discounts and rebates from the manufacturer have been taken into account by the insurance plan or its pharmacy benefit manager.

Out-of-pocket threshold

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

Pharmacy Benefit Manager (PBM)

A company that manages prescription drug benefits for health insurers and Medicare Part D plans, often negotiating drug prices and rebates with manufacturers.

Chronic Care Drug

A prescription medication used for the long-term management of ongoing health conditions, such as asthma, diabetes, or heart disease, as specifically defined in the bill.