#COPAY VS COINSURANCE PLUS#

Whether you have insurance or not, you can chat with a doctor through K Health for a low-cost.Ī copay, unlike coinsurance, is a flat, predetermined rate that your health insurance plan charges you for medical procedures, doctor’s visits, and prescription medication.ĭifferent procedures and medications may have different copay rates.īut if you pay for a specific procedure multiple times, your copay will always be the same. You would then have a base cost of $5,000 or more for that same procedure. Say the medical procedure previously mentioned is $2,000 in your healthcare network and you don’t have health insurance. The costs your coinsurance percentage pays for is often less than what you would pay if you didn’t have insurance.

#COPAY VS COINSURANCE PLUS#

If you have not met your deductible by that point, you would pay $480 the $100 deductible plus the 20 percent of your remaining costs ($1,900). Your insurance company then pays the remaining $1,600. If you have paid your deductible, your coinsurance percentage is 20%, and you receive a bill for $2,000, then your coinsurance is $400. Once you have paid that $100 for your medical expenses (fulfilling your deductible), you are responsible for the coinsurance percentage. If your deductible is $100, you will need to pay $100 up front before your health insurance begins to pay, and you will only pay coinsurance. When people talk about coinsurance, they are referring to the percentage of the cost you cover after meeting your deductible.Ī deductible is what you must pay up front before your health insurance plan starts to pay your medical costs.

out-of-network when choosing your doctors.įinally, we review if you can use both your coinsurance and copay together. Next, we cover their similarities and differences, what out-of-pocket maximums are, and how costs vary when you stay in-network vs. In this article, we discuss what both coinsurance and copays are and how they work with your health insurance. These terms are similar enough that you might not be able to tell the difference between them.Īll three might be part of your health insurance plan, but they have different meanings and applications.

When you are looking for health insurance, you may hear the terms coinsurance, copay, and deductible.

Copay vs coinsurance