Coinsurance

Coinsurance refers to the percentage of costs of a covered healthcare service that a policyholder pays after they’ve paid their deductible. This arrangement is common in health insurance policies and is designed to Share the financial responsibility between the insurer and the insured.

For example, if your health insurance plan has a coinsurance rate of 20%, and you receive a medical bill of $1,000 after meeting your deductible, you would be responsible for paying $200 (20% of $1,000), while the insurance company pays the remaining $800.

In a different case, if a policyholder has a deductible of $1,500 and then undergoes a surgery costing $10,000, they must first pay the deductible. After that, with a coinsurance rate of 30%, they would pay 30% of the remaining $8,500, which equals $2,550. Thus, the total out-of-pocket cost for the policyholder would be $1,500 (deductible) + $2,550 (coinsurance) = $4,050.