Copayment and Coinsurance in Health Insurance Policy Georgia GA
Reader’s Question:
Is there a difference between the words copayment and coinsurance? What do these mean? I’ve heard them being used interchangeably, so I wonder. This is Mike from Georgia.
Mike
Atlanta, GA
Hello Mike of Atlanta! I bet we all wish we never had to spend a single cent when we go see a doctor. We have health insurance coverage after all but sadly that is not the case. The amount of money you have to pay physicians whenever you are in need of them is called copayment. The rest of the expense will be shouldered by the health insurance company. Buying prescription drugs is the same story. How much the copayment will be depends on the terms of your health insurance policy. HMOs or Health Maintenance Organization.
Coinsurance is similar but the term is used for health insurance policy with broader coverage. It may come in various proportions such as 80/20, 70/30 or 90/10. So for instance, you find yourself in hospital, 80 percent of the medical cost will be covered by your health insurance policy. Twenty percent of it will be paid by you.
One basic difference between the two is that copayments are set in fixed amounts that can go as low as $15 and as much as $40. It really depends on the type of medicine you purchase. Buying generic drugs means you pay less. Refer to your health insurance policy for details.
Tags: Health Care, health insurance
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