What is coinsurance?

Coinsurance is your share of the costs for a covered health care service, calculated as a percent of the allowed amount for the service, often for more significant services such as a hospital or out-patient procedure. When you use services subject to coinsurance, your insurer pays their share and you pay yours. Typically, you start paying coinsurance after you've paid your plan's deductible. 

Coinsurance is different from a copay, generally applied to a physician visit or prescription drugs, which is a fixed dollar amount for services and is not typically dependent on meeting your deductible. 
  • Under the ACA some essential benefits like vaccinations and an annual wellness visit are included without cost sharing of any kind, including coinsurance or co-payments. 
Doc#59 R11-13-17