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Introducing Healthcare 101: Coinsurance, Copayments and Deductibles

Have you ever felt like your health insurance policy was written in another language? Healthcare and health insurance don’t have to be confusing or intimidating. With over 8 million people getting brand new health insurance policies, this is a great time to review some of the vocabulary and jargon people come across when dealing with healthcare. Today, we break down a few common terms to help you manage your healthcare with more confidence.

Coinsurance

This amount represents a percentage of a covered healthcare service that you are responsible for paying. Your health insurance pays the remainder. This is separate from any deductibles that you owe. Here’s an example: If the contracted rate for a visit to your medical provider is $100 and your coinsurance rate is 20 percent, you would owe $20. In some cases, if your provider charges more than your insurance is willing to pay, you may responsible for the difference.

Copayment

This amount is based on a fixed rate that you pay for certain healthcare services and is usually due at the time of service. Your health insurance provider along with your employer sets copayment rates. The amount may vary based on the type of service and whether or not the medical provider is in network or out of network.

Deductible

This amount is what you must pay out of pocket for healthcare services before your health insurance starts to pay for any expenses.

Stay tuned for more healthcare and insurance tips from CareSpot!