What are Co-pays, Coinsurance, Deductibles and Out-of-Pocket Maximums?
A co-pay is a designated dollar amount paid by the insured to receive specified services. This is payable at the time of service. Many insurance companies offer plans that have co-pays for doctor visits, prescription drugs and emergency room visits ($10, for example). Co-payments are separate from the deductible amount and normally do not apply toward the annual deductible. Additionally, the deductible does not usually need to be satisfied before a co-payment applies. Please refer to the Summary of Benefits provided by your health plan. Coinsurance is a cost-sharing requirement under certain health insurance policies. It requires the insured (you the patient) and the insurer (employer or health plan) to pay a portion or percentage of the costs for covered services. A typical coinsurance plan might be referred to as 80/20 , which means the insurer pays 80% of the allowable and the insured pays 20%. Please refer to your plan document for your actual benefit. The deductible is the amount
