Coinsurance is simply a fancy way of saying splitting the bill.
Health insurance plans come in a variety of different coinsurance options, however the most common ones you'll find include 70/30, 80/20 and in some cases 90/10.
Those numbers represent the percentage each of you will be paying after you meet your deductible.
Let's take a look at an example
If you have a plan with a $1,000 deductible and 80/20 coinsurance, here's how the numbers breakdown.
So you are in need of an MRI on your aching knee and you get a bill of $2,000 for that test. If this is the first time “using” your health insurance that year, you will pay the first $1,000 of that bill yourself and split the other $1,000 with your health insurance company.
With 80/20 coinsurance, that means your insurance company will pay $800 and you will pay $200.
You will continue to split those bill until your reach your policy's out-of-pocket maximum.
After you reach that maximum limit, all covered, in-network services will be paid for during the benefit period (fancy word that normally means in a year)
A plan with zero percent coinsurance means that once you meet your deductible you won't have to pay any more money through coinsurance.
Your deductible and out-of-pocket maximum become the same number.
Tip: If you are considering a Health Savings Account plan, I usually recommend considering a plan with 0% coinsurance.
Watch the short video below for a more detailed explanation on how coinsurance works on your health insurance policy.
Coinsurance is simply a fancy way of saying splitting the bill.
Health insurance plans come in a variety of different coinsurance options, however the most common ones you'll find include 70/30, 80/20 and in some cases 90/10.
Those numbers represent the percentage each of you will be paying after you meet your deductible.
Let's take a look at an example
If you have a plan with a $1,000 deductible and 80/20 coinsurance, here's how the numbers breakdown.
So you are in need of an MRI on your aching knee and you get a bill of $2,000 for that test. If this is the first time “using” your health insurance that year, you will pay the first $1,000 of that bill yourself and split the other $1,000 with your health insurance company.
With 80/20 coinsurance, that means your insurance company will pay $800 and you will pay $200.
You will continue to split those bill until your reach your policy's out-of-pocket maximum.
After you reach that maximum limit, all covered, in-network services will be paid for during the benefit period (fancy word that normally means in a year)
A plan with zero percent coinsurance means that once you meet your deductible you won't have to pay any more money through coinsurance.
Your deductible and out-of-pocket maximum become the same number.
Tip: If you are considering a Health Savings Account plan, I usually recommend considering a plan with 0% coinsurance.
Watch the short video below for a more detailed explanation on how coinsurance works on your health insurance policy.