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Answered 2008-08-26 20:39:45

Coninsurance is the amount you are required to pay for medical care in a fee-for-service plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.

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On a health insurance policy, a "deductible" is a specified amount which the insured/beneficiary must pay out of their own pocket, before their insurance will pay any covered medical services. After the deductible amount is met, a "coinsurance" is a percentage amount which the insured/beneficiary is responsible for. For example, if an insurance policy is an "80/20 plan", this means that the insurance company pays 80% of medical services, and the patient (insured) is responsible to pay the remaining 20% (coinsurance).


Under certain health insurance plans, 'coinsurance' is the percentage of a covered medical expense you may be required to pay after you've paid your copayment and/or deductible. Not all health insurance plans require coinsurance. It's a confusing concept, so here's an example: Joe gets sick and goes to the doctor. He may pay a copayment for his office visit, but if the doctor orders special tests or x-rays, Joe may also be required to pay coinsurance for those tests. Say, for example, that Joe is given an x-ray and the total charge for the x-ray is $100. Even if Joe has already fulfilled his deductible for the year, he may still have to pay coinsurance toward that charge. If his health insurance policy requires 20% coinsurance, Joe will pay $20 toward the total cost of the x-ray, while his health insurance company will pay the remaining $80.


Coinsurance refers to a type of insurance whereby the insured pays a share of the payment made against a claim.



It means that the insurance has a maximum payout combining costs of drugs, hospitals, doctor visits, therapy, etc. Insurance is a business and they want to make money.


It's secondary or tertiary insurance that is held to cover any medical expenses the primary insurance policy does not cover or does not cover completely.


After the claim is processed the patient will be responsible for any coinsurance, deductible; and any of the insurance companies non-covered services that were rendered. Hope this helps! Evan


Is the patient responsible for deductible and coinsurance if primary insurance paid more than secondary would have allowed.


Some health insurance plans offer a AD&D Life Insurance Policy. That is why you would name a beneficiary for a health insurance company.


Coinsurance in medical health (casualty) is sharing of costs between insurer and insured, and in property insurance it is were the risk( one risk) is shared between different insurance companies. Reinsurance is insurance for an insurance company, where by an insurance companies seeks for indemnification in case that a stated loss takes place.


Yes, unless your insurance policy says 100% covered.


The answer to this question depends on what kind of secondary insurance you have - is it a group health plan? Is it a supplement? If Medicare is primary, there are still deductibles, copays, coinsurance that would need to be satisfied by your secondary insurance. Based on your question, I'm assuming that you have a group health plan with a copayment as your secondary insurance. If so, then yes, you would pay your copayment but it would not exceed the part B deductible.


By "Obama Health," I assume you mean, health insurance reform. The government will not be taking over any private insurance provider as a result of health insurance reform.


This is the amount paid by the insurance company to the doctor. It is the negotiated rate less the amount that you paid in the form of a copay, a coinsurance, or a deductible.


Eighty twenty coinsurance is usually expressed 80/20 by insurance companies. The first number (80) represents the percentage of payment an insurance company will pay for a service and the second number (20) is the percentage the person receiving the service is required to pay. Other popular coinsurance amounts are 70/30, 60/40, 50/50. It is important to note a couple of factors in determining when an insurance company will pay coinsurance. First, an insurance company will only pay 80% on what the insurance considers the "allowed" amount of a fee. Generally insurance companies have fee schedules which designate the maximum amount they will pay on any particular service. This allowed amount could be more or less than the fee that is charged for the service (usually the allowed amount is lower than the fee). Second, an insurance company will only pay 80% for services rendered after the insured has satisified their deductible. Therefore, if your insurance policy has a deductible of $500, the insured must pay out $500 towards their claims then insurance companies will consider paying 80% coinsurance on the remaining balance of unpaid services. Coinsurance does not apply to deductible amounts. Third, the service that is rendered must be a covered service under the insurance policy. If the service is not a covered service most insurance policies will not pay for the service, and usually it does not apply towards the deductible either. Lastly, if the provider of the service does not have a contract with your insurance company, the insured will most likely owe the difference between the allowed amount of the insurance company and the billed amount from the provider. Coinsurance does not apply to the portion of the fee that exceeds the insurance companies allowed amount. Billing the insured for this difference is referred to as balance billing.


If it is health insurance quote. It means Each Employee


A Copay is a flat dollar amount that needs to be paid to a health care provider for services rendered. There may or may not be "coinsurance" applied after this flat dollar fee is paid. A Copay varies by the health plan benefits. Typical physician office copays are $20, $30 or $35 per visit.


Government run insurance would mean that everybody would have insurance coverage. It would be affordable for the people who do not have the means to carry health insurance. It also would mean that no American can ever be turned away for medical treatment, because they do not have insurance.


25% of Hispanics in the USA do not have health insurance. do not have health insurance?


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If you mean, "why," one possible reason is that health insurance reform required health insurance companies to spend the money they receive in premiums on, um, actual health care and not excessive overhead such as inflated executive compensation. .


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