What is Coinsurance?

by Guest » Thu May 27, 2010 01:58 pm
Guest

Looking at a quote for health insurance, I see the decutible in and out of pocket. How does the coinsurance percent and coinsurance limit work?

Total Comments: 14

Posted: Sun Oct 24, 2010 10:19 pm Post Subject:

Coinsurance An arrangement under which the insured person pays a fixed percentage of the cost of medical care after the deductible has been paid. For example, a health plan might pay 80% of the allowable charge, with the enrollee responsible for the remaining 20%; the 20% amount is then referred to as the coinsurance amount.
Coinsurance maximum This is the maximum dollar amount of Covered Expenses for which the Member is responsible in a Calendar Year. After that maximum is reached, this plan will pay 100% of Covered Expenses incurred during the remainder of that Calendar Year.

Insurance in the U.S.

Posted: Mon Oct 25, 2010 01:34 am Post Subject:

Coinsurance is a type of insurance in which the insurer and the insured split risks with each other. In addition to lowering the cost of insurance for the insured, coinsurance also benefits other people who are insured with the same company, by ensuring that the insurance company will be able to pay all claims. Before purchasing coinsurance,

Posted: Mon Oct 25, 2010 06:31 am Post Subject:

Coinsurance is a type of insurance



Couldn't be MORE WRONG than to make such a statement. No one buys a "Coinsurance Policy" -- but people buy insurance policies that include coinsurance provisions.

Milfordct's explanation above is correct. "Coinsurance maximum" may also be described variously as "Stop Loss Limit" or "Out of Pocket Maximum".

The term "coinsurance" is also prevalent in Property & Casualty Policies such as homeowner's insurance. But in those policies the 80% factor is a very different discussion. Fail to insure your property for at least 80% of its actual cash value/replacement cost will cause you to have a smaller percentage of your actual loss paid than you might expect.

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