Coinsurance is the determined percentage of costs that beneficiaries pay after reaching their deductible. Insurers, including Medicare and Medicaid, cover the remaining medical costs. Coinsurance only applies to services covered under the plan.
For example, under an “80/20” plan, the individual would pay 20% of the cost until they reach their out-of-pocket limit. The insurer would pay 80% of the price.
What is the difference between coinsurance and copays?
Coinsurance and copays both refer to the amount of money policyholders pay for healthcare insurance. However, a copay is distinct in that it is a determined rate for medical visits, prescription drugs and other services.