HRMan Benefits' Blog


Understanding Your Copayment and Coinsurance

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As your broker, education is the key to our success. We want to help employers and their employees understand their benefits and get the most from their health care plan. Health plans have many different components, and we’re here to breakdown those components to help you better understand their meaning. A copayment and coinsurance are two parts that make up your plan. All plans have some form of copayment and coinsurance in place, but some plans may utilize just one. Check your plan!

How a copay works:Closeup of happy businesspeople enjoying

A copayment is a fixed amount you pay for a covered health care service, usually when the service is provided. For example, you might pay $30 to see a doctor and $20 to fill a prescription. The amount can vary based on the specifics of the plan.

How coinsurance works:

Coinsurance is the amount or percentage you pay for certain covered health care services under your health plan. This is typically the amount paid after a deductible is met, and can vary based on the plan design. For example, if the health plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your coinsurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.

Why are these concepts important?

A copayment and coinsurance are integral parts of your health care plan. Understanding how these components work will help you pick a plan that will meet your financial needs. As your broker, it’s our job to provide the best quality care and assist you in your decision making process.

Check out our blog regularly, as we educate our readers on a weekly basis on health care and all the fun that comes with it. For more information on health care terms, check out our Benefits Glossary.

If you would like to learn more about similar concepts, plans, or access other information please contact us. We’re here to help you understand your benefits and provide care that exceeds expectations. Our educational material will enable you to make decisions with both ease and confidence.

Have a great week!

Author: hrmanbenefits

Anderson Thornton Consultants is a full-service insurance brokerage and employee benefits management firm based in Tampa, Florida, servicing businesses all over the United States.

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