When does coinsurance apply?

When does coinsurance apply?

• A. Before deductible is met.
• B. Only after reaching out-of-pocket max.
• C. For all services regardless of deductible.
• D. After deductible is met.

Answer: (D)

Coinsurance is the share of covered costs you pay after you've met your deductible. You usually pay the full allowed amount up to the deductible, and once the deductible is satisfied, you begin paying a percentage of subsequent costs (the coinsurance) until you reach the out-of-pocket maximum, after which the plan pays 100% of covered services. For example, with a deductible of $1,000, coinsurance of 20%, and an out-of-pocket maximum of $3,000, you cover the first $1,000, then 20% of remaining costs until your total out-of-pocket payments reach $3,000, at which point the insurer covers all further covered costs. Some services (like certain preventive care) may be exempt from coinsurance, but in general coinsurance starts after the deductible is met and stops at the out-of-pocket maximum.

Coinsurance is the share of covered costs you pay after you've met your deductible. You usually pay the full allowed amount up to the deductible, and once the deductible is satisfied, you begin paying a percentage of subsequent costs (the coinsurance) until you reach the out-of-pocket maximum, after which the plan pays 100% of covered services. For example, with a deductible of $1,000, coinsurance of 20%, and an out-of-pocket maximum of $3,000, you cover the first $1,000, then 20% of remaining costs until your total out-of-pocket payments reach $3,000, at which point the insurer covers all further covered costs. Some services (like certain preventive care) may be exempt from coinsurance, but in general coinsurance starts after the deductible is met and stops at the out-of-pocket maximum.