Copays & Coinsurance Guide
Your share of the costs. We explain copays, coinsurance, and how they all factor into your actual out-of-pocket expenses.
Flat copays
% coinsurance
Out-of-pocket cap
Your share of the costs. We explain copays, coinsurance, and how they all factor into your actual out-of-pocket expenses.
A copay is a fixed price for a service: $30 for a doctor visit, $60 for a specialist, $15 for a generic prescription. You pay it at the visit, and it usually does not depend on your deductible status.
Coinsurance is your share of costs after meeting your deductible, commonly 20 percent for you and 80 percent for the plan. On a $10,000 procedure, that is $2,000 out of your pocket, until you reach your out-of-pocket maximum.
Add your deductible spending and coinsurance together and the plan stops charging you once you hit the annual maximum. When comparing plans, that number tells you your realistic bad-year cost. We put it front and center on every comparison we build.
Let our team find the right coverage for your situation. Professional guidance, no pressure.