what is a co-insurance?
Introduction
Coinsurance is a health insurance term that refers to the percentage of a patient’s bill that they have to pay. For example, if your plan has an 80% coinsurance rate, you will pay 20% of any covered medical expenses yourself and the rest will be paid by your insurance company. In this case, if you have a $5,000 deductible and need to use $2,000 worth of services before coverage kicks in (80% coinsurance), then you would pay $1,200 out of pocket before your insurance pays anything further
Coinsurance is the amount you pay for covered health care after you meet your deductible.
Coinsurance is the amount you pay for covered health care after you meet your deductible. It’s a percentage of the total cost of your visit or prescription and it’s paid by you and/or your insurer.
Coinsurance can be thought of as an insurance policy that pays part of your medical bills based on how much coverage you have purchased through it. If someone has a $1,000 deductible and pays $100 in coinsurance per year, then they would have spent $200 out-of-pocket on their prescriptions during the year (the remaining $800 would be paid by their insurance company).
For example, if a patient has a $5,000 deductible and an 80% coinsurance rate, they will pay $1,200 out of pocket (80% of $5,000) before their insurance pays 100%.
For example, if a patient has a $5,000 deductible and an 80% coinsurance rate, they will pay $1,200 out of pocket (80% of $5,000) before their insurance pays 100%.
Coinsurance rates vary by plan and age. You can lower your coinsurance rate by increasing the deductible or co-payment amount.
Coinsurance rates vary by plan and age.
Coinsurance rates vary by plan and age. The amount you pay for a service or procedure is called coinsurance, which means “inheritance.” Coinsurance is a percentage of the total cost of care. For example, if you have an open-ended deductible and $500 deductible on your health plan, then you will pay 20% (20% of $2,000) for all covered services—whether they’re in-network or out-of-network—until your out-of-pocket limit is reached.
Coinsurance applies only to services that are covered by your policy; it does not apply to any other services that may be offered by your doctor or hospital. If you receive treatment from an outside provider who charges more than what’s covered by your insurance company’s network rate schedule (such as specialists), then all costs associated with those treatments will be deducted from the amount left after paying coinsurance amounts proportionally based on their cost relative to what was expected when seeking treatment elsewhere without insurance coverage beforehand.”
This means that if you have a $1,000 deductible, you would pay 20% of the first $1,000 in medical expenses and then 80% of everything else. For example, if your doctor charges $2,000 for an office visit plus procedures such as x-rays or blood tests, then your coinsurance would be 20% of the $2,000 total cost (or $400).
From there, your insurance company would pay 80% of the remaining $800 (or $640). So in the end, you would pay $400 plus $160 for a total of $560. Learn more
Conclusion
In summary, coinsurance is the amount you pay for covered health care after you meet your deductible. It’s a method of spreading out your overall health care costs over time, rather than paying it all up front. Coinsurance rates vary by plan and age.
