Which term describes a fixed percentage of covered charges after the deductible is met?

Which term describes a fixed percentage of covered charges after the deductible is met?

• A. Deductible
• B. Coinsurance
• C. Primary Insurance
• D. Medicare

Answer: (B)

Coinsurance is the cost-sharing arrangement where, after you meet the deductible, you pay a fixed percentage of covered charges and the insurance plan pays the remainder. For example, if your plan has 20% coinsurance on a covered bill, you would owe 20% of the allowed amount and the insurer would cover 80% until you reach your out-of-pocket maximum. This differs from a deductible, which is the amount you must pay before the plan starts sharing costs, and from a copayment, which is a fixed dollar amount per visit. Primary Insurance and Medicare describe who pays rather than how costs are shared, so they aren’t the mechanism described here.

Coinsurance is the cost-sharing arrangement where, after you meet the deductible, you pay a fixed percentage of covered charges and the insurance plan pays the remainder. For example, if your plan has 20% coinsurance on a covered bill, you would owe 20% of the allowed amount and the insurer would cover 80% until you reach your out-of-pocket maximum. This differs from a deductible, which is the amount you must pay before the plan starts sharing costs, and from a copayment, which is a fixed dollar amount per visit. Primary Insurance and Medicare describe who pays rather than how costs are shared, so they aren’t the mechanism described here.