Co Insurance

The definition of Co Insurance, and how it fits into the Zenefits Health Insurance Marketplace

What is a Co-insurance?

Coinsurance is a percentage of the total cost of a medical service that is paid out-of-pocket, but the percentage may vary depending on whether the service received is inside or outside of the plan’s network. Coinsurance does not have to be paid until after the plan’s deductible has been met.

 

How does co-insurance work?

Coinsurance is generally used for more involved and less common services, like hospital stays and medical equipment. Coinsurance is also heavily used for Out-of-Network services.

Example:

Amina has a $ 2 ,000 deductible that she already reached, and 20% coinsurance.

If Amina then incurs a $250 medical bill, Amina would pay $50 out of pocket, and her insurance company would pay $200.