Sometimes the terms in a health insurance policy can seem like a different language. While it’s important to understand all of the relevant terms in a policy, this is especially true when it involves how much you’re required to pay. Here are the differences between deductibles, copayments and coinsurances.
Deductible
The deductible is the amount you must pay out-of-pocket for covered healthcare before your insurer begins to share the costs. For example, if your deductible is $2,000, you are responsible for the first $2,000 of your medical bills. Generally, plans with higher deductibles feature lower monthly premiums, which can be a strategic financial choice depending on your specific health needs.
Routine and preventative care is sometimes covered, either in full or in part, before meeting your deductible. Whether a particular medical service is covered beforehand depends on the service and your specific policy. If you’re in New Windsor, NY, our team at Kalare Tech can help you review your policy’s terms if you’re unclear about the deductible (or anything else).
Copayment
A copayment is a fixed dollar amount you pay for a specific service, usually at the time you receive care. This is frequently called a “copay.” You might have a $30 copay for a primary care visit or a $15 copay for a prescription. Copays are often required even after you have met your deductible, providing a predictable cost for routine visits.
Coinsurance
Coinsurance is your share of the costs of a covered service, figured as a percentage. This typically kicks in after you’ve met your deductible. If your plan has a 20% coinsurance rate and the allowed amount for a procedure is $1,000, you would pay $200 while the insurer covers the remaining $800. Coinsurance functions like a copayment, except your responsibility is a portion of the total cost rather than a fixed amount.
Call Us for Help With Your Health Insurance
If you want help with these or other aspects of your health insurance policy, contact us at Kalare Tech. We’ve assisted many New Windsor, NY residents with their health insurance needs.
