what is coinsurance in health insurance

what is coinsurance in health insurance

1 year ago 39
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Coinsurance is a cost-sharing feature in health insurance plans where the insured individual and the insurance company share the costs of covered medical expenses after the deductible has been met. Here are some key points to understand about coinsurance:

  • Coinsurance is usually figured as a percentage of the amount allowed to be charged for services.
  • It applies after the deductible has been met, and the insured individual is responsible for paying a portion of the remaining costs.
  • The coinsurance ratio specifies the percentage that the insured individual is responsible for paying, while the health plan covers the remaining portion.
  • Coinsurance can vary based on the specific health insurance plan and the services received.
  • Generally, plans with low monthly premiums have higher coinsurance, and plans with higher monthly premiums have lower coinsurance.

For example, if an individual has a coinsurance of 20% and the cost of a covered medical service is $100, they would pay $20, and the insurance company would pay the remaining $80. Its important to note that coinsurance is different from copays and deductibles, which are other cost-sharing features in health insurance plans.

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