What is the differance between a copay and coinsurance?

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PostPosted: Mon Jul 21, 2008 9:13 pm   Post subject: What is the differance between a copay and coinsurance?  

can anyone tellme the difference?
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PostPosted: Mon Jul 21, 2008 9:25 pm   Post subject:   

I think this belongs in health insurance, but here is the difference.

Copay is a set dollar amount you pay for smaller services such as doctor visits and tests, etc.

Co-insurance is the percentage you pay after meeting your deductible for more expensive services such as hospitalizations and surgery.

for example if you have a 80/20 plan you pay 20% after deductible and the insurance company pays 80% after you meet the deductible.

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PostPosted: Tue Jul 22, 2008 6:41 am   Post subject:   

Both co-pay and co-insurance are devised to prevent the possibilities health insurance scams from the patient's side. Health insurance plans pay for the medical expenses, but that is rarely 100%. The health insurance providers require the applicant to pay a certain share of the entire medical cost in the form of copay and coinsurance. And the amount of copay/coinsurance gets decided at the time of applying for the policy and plays a role in determining the premium rate.
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Sebastian Alonso
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PostPosted: Tue Jul 22, 2008 7:24 am   Post subject:   

Right, both copay and coinsurance are associated with health plans.

Co-pay- when the policy paper describes that the policy holder is required to pay a fixed amount everytime towards the treatment (doctors' visits, prescription drugs) before the policy benefits kicks in.

Coinsurance-the coinsurance is same as copay. However, the only difference is that it is described as a percentage of the total cost of the medical care.

Coinsurance has certain demerits, as it is described as a percentage of the total cost, it is tend to vary with the amount of the care received, whereas, the amount of co-pay will remain fixed throughout, and thus is more predictable in terms of the out-of-the-pocket pay.

Thanks,
Carol
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PostPosted: Tue Jul 22, 2008 5:40 pm   Post subject: Link  

Here is a link to a website that has a glossary of terms that you may find useful... whataquote.com. Look under the Resources section.

*link deactivated as per the forums rules
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PostPosted: Wed Aug 06, 2008 1:48 pm   Post subject:   

These terms are very confusing to my clients so I created a blog entry entitled " Health Insurance definitions: What is a deductible?"

It explains the differences between deductibles, co-pays, coinsurance and out-of-pocket maximums. If you are interested, click on the blog link in my signature.

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PostPosted: Mon Aug 10, 2009 6:35 pm   Post subject:   

here is an article about it:
http://ezinearticles.com/?The-Difference-Between-Copay-and-Coinsurance &id=291513
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