Question

What is the difference between an insurance plan's co-pay and coinsurance?

1) A co-pay is a set amount due at the time of service for an office visit while coinsurance is a percentage that the patient is responsible for, for certain services.
2) A co-pay is a set amount the patient must pay at the time of service while coinsurance patients pay anything.
3) A co-pay is a set amount that the insurance pays for service while coinsurance is a partial insurance plan.
4) Co-pays and coinsurance pay half of a service, and the patient is responsible for the other half.

Answer 1

An insurance plan's co-pay is a fixed fee paid at the time of service, whereas coinsurance is a percentage of the service cost paid by the policyholder after meeting the deductible.

Step-by-step explanation:

The difference between an insurance plan's co-pay and coinsurance primarily lies in their payment structure.

A co-pay is a predetermined flat fee that a policyholder pays at the time of service, such as $20 for an office visit or $250 for an emergency room visit.

In contrast, coinsurance refers to the percentage of the service cost that the patient is responsible for after their deductible has been met.

For instance, with a 20% coinsurance rate, the patient would be responsible for paying 20% of the total costs, while the insurance company would cover the remaining 80%.