Real answers for your healthcare questions
What is the difference between a copay and coinsurance?
Answer
A copay is usually a fixed dollar amount you pay for a covered service, while coinsurance is a percentage of the allowed cost that you pay. A health plan can use both, depending on the service.
What to Know
You might pay a $30 copay for a primary care visit. With 20 percent coinsurance, a covered service with an allowed cost of $1,000 could leave you responsible for $200 after any applicable deductible. The actual amount depends on the plan's rules and negotiated rate.
What to Do Next
Check your plan's benefit summary for the services you use most. When comparing plans, do not look at the premium alone. Copays and coinsurance can make a significant difference in your total yearly cost.
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