Dernières Heures : Guy Philippe annonce son retour dans les jours à venir - Ses collègues vont - ils l'accepter au sénat ? Voici toutes les dernières informations...

Dernières Heures : Guy Philippe annonce son retour dans les jours à venir - Ses collègues vont - ils l'accepter au sénat ? Voici toutes les dernières informations...

Autres détails sur Guy Philippe : Guy Philippe au téléphone depuis sa cellule de prison...

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Coinsurance for Health Insurance


Coinsurance and copays are both forms of cost sharing between health insurance companies and consumers. But there are key differences between them that consumers should understand. In short, copays are flat fees members pay for things like visiting a doctor’s office or a prescription drug. Coinsurance is a percentage of the cost for a health service or drug paid by the member.

What is a Copayment (Copay)?

A copayment, or copay, is a flat fee for a healthcare service or a prescription drug that is predetermined by a member’s health insurance plan. Copays are one way that insurers share the cost of medical services with policyholders, with the fees paid depending on the plan, medical service or drug. These fees are a fraction of the actual cost of the service provided.
Copays listed in health insurance plans can take effect either before or after an annual deductible has been met. In cases where a "deductible applies" or those that read "$x copay after deductible" a policyholder must pay for 100% of all costs for their health service until they've hit their deductible. After you've reached this figure, the reduced flat fee of a copayment applies.
The other situation is where the "deductible is waived" and cost sharing takes place immediately. In most health plans for example, visits to a primary care physician (PCP) have the deductible requirement waived for a certain number of visits (typically the first three in a year). Once a member has used their alloted number of copay visits to their primary care physician, they must pay for any additional visits out-of-pocket, up to their deductible at which point the copay amounts again apply.


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