{"id":1801,"date":"2020-08-11T07:57:00","date_gmt":"2020-08-11T14:57:00","guid":{"rendered":"https:\/\/www.insureone.com\/knowledge-center\/?p=1801"},"modified":"2020-08-10T18:59:41","modified_gmt":"2020-08-11T01:59:41","slug":"what-is-coinsurance","status":"publish","type":"post","link":"https:\/\/www.insureone.com\/knowledge-center\/employee-benefits\/what-is-coinsurance\/","title":{"rendered":"What Is Coinsurance? 4 Questions Answered"},"content":{"rendered":"\n

Let\u2019s face it\u2014health insurance can be difficult to comprehend. Between all the different terms and conditions, there\u2019s a lot to know. Many people don\u2019t have the right health insurance because they don\u2019t understand it. <\/p>\n\n\n\n

One term you may have seen is coinsurance, which offers pros and cons for consumers. In this article, we\u2019ll look at what it is, how it works, and other things you should know about this cost.<\/p>\n\n\n\n

What Is Coinsurance and How Does it Work?<\/h2>\n\n\n\n

In a nutshell, coinsurance is the health care cost shared between you and your insurance company<\/a>. It is the amount someone insured needs to pay against a health insurance claim after they have hit the deductible for that year. <\/p>\n\n\n\n

Coinsurance is usually a fixed percentage. It allows you to split the cost of medical services with your health insurance until you reach your out-of-pocket maximum.<\/p>\n\n\n\n

For example, if your coinsurance is 80\/20, 80 percent of your medical expenses are covered by your insurance plan. The 20 percent that is left is your responsibility as the insured. When your medical expenses reach your out-of-pocket limit, your insurance company pays all costs left.<\/p>\n\n\n\n

Like health insurance policies, home property insurance policies contain coinsurance provisions. You can also get it for car insurance.<\/p>\n\n\n\n

Is it Better to Have a Copay or Coinsurance?<\/h2>\n\n\n\n
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A copay is a set dollar amount for when you receive healthcare services for prescription medications. Your insurance company determines these fees. <\/p>\n\n\n\n

Copays and coinsurance count toward your out-of-pocket maximum. Additionally, while copays differ according to the service you receive, the out-of-pocket percentage you pay for coinsurance is always the same.<\/p>\n\n\n\n

Copay and coinsurance provisions are both ways for insurance companies to spread risk. So, which is better? Well, it depends on:<\/p>\n\n\n\n