What is the difference between a deductible, copayment, and coinsurance?
A deductible, copayment, and coinsurance are all terms related to healthcare expenses. A deductible is the initial amount a policyholder must pay out-of-pocket before the insurance coverage starts. For example, if a plan has a $500 deductible, the policyholder must pay $500 before the insurance covers any expenses. A copayment, on the other hand, is a fixed fee paid by the policyholder for certain medical services, such as doctor visits or prescription medications. For instance, a plan might require a $20 copayment for each doctor visit. Coinsurance refers to the percentage of the costs shared between the policyholder and the insurance company after the deductible has been met. So, if a plan has a 20% coinsurance provision, the policyholder pays 20% of the medical costs, and the insurance covers the remaining 80%. Therefore, while the deductible is a set amount, copayments are fixed fees, and coinsurance involves a shared percentage of expenses.
Answered Nov 1, 2023
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