FAQ: What Is A Coinsurance?

Typically an insurance policy will have a deductible, a coinsurance or copayment and an out of pocket maximum. Although every insurance plan is different and may not have each of these, it’s important to understand them and how they work. It’s especially useful when it comes time to choosing future health care plans.

A coinsurance is a percentage of the costs for health care services you are responsible for paying after you’ve met your deductible.

  • For example, if the health insurance plan’s allowed-amount for an office visit is $100, and Dwayne has met his deductible already, his 20% coinsurance payment would end up being $20 (20% of $100).
  • The health insurance company will then pay the rest of the allowed amount ($80).

Coinsurance amounts can be different depending on the type of service. You may have a 10% coinsurance for chiropractic visits yet have a 20% coinsurance for exam visits. Some services may not require a coinsurance at all.

For more information regarding insurance benefits, visit www.borjapt.com/blog/health-insurance-101.

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Jaime Curl

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