What is coinsurance?

Prepare for the Business of Healthcare and Health Policy Test. Study with multiple choice questions and explanations to ace your exam!

Multiple Choice

What is coinsurance?

Coinsurance is the share of covered medical costs that you pay after you’ve met your deductible, expressed as a percentage. For example, with an 80/20 plan, you would pay 20% of the cost and the insurer would pay 80% after the deductible is satisfied, until you reach the out-of-pocket maximum. This differs from a fixed copayment, which is a set dollar amount you pay for a specific service at the time of care, and from the deductible, which is the amount you must pay out of pocket before coinsurance kicks in. The out-of-pocket maximum caps what you pay in a year for covered services.

Coinsurance is the share of covered medical costs that you pay after you’ve met your deductible, expressed as a percentage. For example, with an 80/20 plan, you would pay 20% of the cost and the insurer would pay 80% after the deductible is satisfied, until you reach the out-of-pocket maximum. This differs from a fixed copayment, which is a set dollar amount you pay for a specific service at the time of care, and from the deductible, which is the amount you must pay out of pocket before coinsurance kicks in. The out-of-pocket maximum caps what you pay in a year for covered services.

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