Co-Insurance - Health Insurance Definition
The Co-Insurance is the amount
you pay for specific services. The amount of the
coinsurance amount is a percentage of the total
cost. There are some important differences between
a policy that requires the insured to pay a percentage
and a policy that has a co-payment.
You may find that the co-insurance policy is
less expensive. That’s because there’s
the potential for your portion to be higher. By
contrast, some policies require that you pay a
set amount for every office visit - usually $20
or $25. As the consumer, you can see that you’d
be ahead on a typical office visit if you’re
paying a coinsurance payment. A consumer required
to pay twenty percent of a $50 office visit will
only be paying $10. While that sounds great, there
are other important aspects to consider.
A co-insurance policy typically requires that
the consumer pay a deductible
before the insurance picks up any of the cost.
Most doctors can do X-rays, blood work and other
testing in their offices. If you have co-insurance,
you’ll pay a percentage of all those costs.
A co-pay policy will typically require that you
pay only the set amount - regardless of the total
cost of the visit.
So which is better? It all depends on you - the
consumer. Consider whether you’ll be able
to comfortably meet the deductible as you compare
costs. If the coinsurance has a $1,000 per-family
member deductible, you may find that you aren’t
even meeting that amount in a year’s time,
which means you’ve paid the premiums
but have still paid the complete cost of your
health care. |
