If your plan’s coinsurance is 20 percent, you’ll pay $20, and your insurance will pay the rest. Let’s say you visit the doctor after you’ve reached your annual deductible, and the cost of the visit is $100. Coinsurance is your share of the cost of a covered health care service after you reach your annual deductible.You almost always pay a copay at the time of service. For example, your plan may require a $25 copay if you go to your doctor when you’re sick or fill a prescription. A copay (sometimes called a copayment) is a flat fee you pay for a covered health care service.Remember that most health plans today have two different deductibles, one for in-network care and a separate deductible for out-of-network care.
For example, if your plan has a $1,000 deductible, you pay the first $1,000 of covered services before your insurance kicks in.
The deductible is the dollar amount you pay for covered health care services before your insurance plan starts to pay.Most health plans have three types of out-of-pocket costs: an annual deductible, copays, and coinsurance. Educating yourself about how health insurance works can help you plan ahead, calculate how much you may need to pay for your health care, and make the most of your health plan. Premiums, deductibles, copays, coinsurance, out-of-pocket maximums-if you’re not really sure what these terms mean, you’re not alone.
It isn’t always easy to understand the different costs that may be part of your health plan.
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