What do the terms copay, Coinsurance and Deductibles mean?

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Copay, Coinsurance, and Deductibles are the insurance terms mostly used in the US.

Copay

This is the amount paid by patients to the doctors, as per the rules of the insurance company. The amount to be paid by the patients is decided by the insurance company, while it doesn’t help in paying any amount.

Coinsurance

Almost all the US citizens have health insurance, usually multiple ones. Some might have only one and in that case, the remaining amount to be paid after the first insurance payment is called as Coinsurance.

The patients usually have three types of insurances called Primary, secondary and tertiary.

If a patient gets admitted and is eligible for insurance, the primary insurance company pays the amount. If it pays 100% of the amount, then the patient has nothing to pay. Otherwise, if it pays some 75% of the amount, that remaining amount is called as Coinsurance. But if the patient has a secondary insurance policy also, then the remaining amount is paid by that company. If still some bills are pending to be paid, the tertiary insurance policy takes care of them.

Deductible

The deductible is the amount you pay for covered health care services before your insurance plan starts to pay. When you already pay some amount as deductible, you are usually left to pay coinsurance only. (As this deductible amount is deduced from the total payable amount).

raja
Published on 16-Jan-2019 12:12:56
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