What is a coinsurance?

“Coinsurance” is a term used by health insurance companies to refer to the amount that you are required to pay for a medical claim, apart from any co-payments or deductible.  For example, if you health insurance plan has a 20% coinsurance requirement then a $100 medical bill would cost you $20.00 and the insurance company would pay the remaining $80.00.

 

What is a deductible?

A “deductible” is a specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims.  Not all health insurance plans require a deductible.  As a general rule, though there are may exceptions, HMO plans typically do not require a deductible, while most Indemnity and PPO plans do.

To see more information about deductibles, click here.

What is a co-payment?

A “co-payment” or “co-pay” is a specific charge that your health insurance plan may require that you pay for a specific medical service or supply.  For example, your health insurance plan may require a $30 co-payment for an office visit or brand-name prescription drug, after which the insurance plan pays the remainder of the charges.

For more information about co-payments, click here.