Decide on the right mix of deductibles, copays and coinsurance that works best for you. Be sure you understand what your cost responsibilities are going to be before you buy any health insurance plan. Coinsurance is when you and your plan both share a percentage of the cost of a service that adds up to 100 percent.įor more information on common health care terms, use this helpful glossary. The insurance plan pays the remainder, so in this example 70 or 70 of every 100 of any covered expense. For example, if a medical service has a 20 percent coinsurance, you would pay 20 percent of the cost and your plan would pay the other 80 percent. What is coinsurance?Ĭoinsurance is when you pay a percentage of the cost for an item or service. If your plan had a $0 prescription drug deductible, your plan would help pay for your prescription drug costs without you having to pay a certain amount first. The department requires copayments to help. For example, if your plan had a $200 prescription drug deductible, you would pay the first $200 of your prescription drug costs before your plan helps to pay. Federal law permits the Medical Assistance program to require copayments from beneficiaries for medical services. There could be a deductible on medical services or on prescription drug services, but not all plans have a deductible. What is a deductible?Ī deductible is the amount you pay for a service before the plan shares the cost of the service with you. Your plan may have a $0 copay for seeing your doctor, for example, in which case you would not have to pay a copay each time you visit your doctor. You may not always have a copay, however. Copays cover your cost of a doctor’s visit or medication. What is a copay?Ī copay is a fixed amount you pay for a health service, seeing your doctor, or filling a prescription. All three are different types of cost sharing, which is the portion you pay for a medical service or prescription drug. The most common types are copays, deductibles, and coinsurance. But when it comes to payment types, it’s helpful to know the meaning of the different terms so you know what form of payment is required.
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