What is Co-insurance on Health insurance anyways… If you are wondering what co-insurance on your health insurance plans means, allow me to briefly explain.

This is will be quick… Coinsurance is just a fancy word for sharing.  It’s the portion that you will start to share with the insurance carrier up to your out-of-pocket maximum.

I am a firm believer in show and tell ie examples.. I learn better that way ;)

Example:  PPO plans $1,000 deductible,   80/20% coinsurance, stop-loss or maximum is $3,000

Here what that means,  Once you meet your deductible of $1,000 health insurance deductible you and the insurance carrier will start to share in the expenses.  The insurance carrier will start to pay 80% of your claims and you pay 20%.  The good news… you do not keep paying 20%.  See once you have met your $3,000 the insurance carrier pays 100% for the remainder of the calendar year/policy year.

Continue reading about health insurance copays

Hold on don’t go skipping away to quickly, you will still have copays on most health insurance plans that will continue after you have met your deductible and coinsurance limit.  Depending on your health insurance plan you may still have coinsurance for mental health and miscellaneous services.  I recommend your refer to your specific health insurance plans summary plan description for full details.  The summary plan description is the line by line how your benefits are covered.

Clear as mud?  ;)  Please let us know if you have any questions/comments or something you want us to discuss.

A few things to consider when looking for a health insurance plan.  Be sure to look at the out of pocket maximum when selecting your new health insurance plan and remember that what ever this amount is you will typically still have your health insurance deductible to add.  They both start over depending if you health insurance plan is based on policy year or calendar year basis.

Have any questions regarding this or any other article?  Would you like to check out your health insurance options?  Give us a call – It’s free ;)

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