What is a deductible?

The “deductible” is a specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims that you submit. Not all health insurance plans require a deductible. As a general rule, HMO plans typically do not require a deductible, while most Indemnity and PPO plans do.

What is coinsurance?

“Coinsurance” is the term used by health insurance companies to refer to the amount that you are required to pay for a medical claim, apart from any co-payments or deductible. Let’s say that your health insurance plan has a 20% coinsurance requirement and does not have any additional co-payment or deductible requirements, then a $100 medical bill would cost you $20, and the insurance company would pay the remaining $80.

What is co-payment?

The “co-payment” or “co-pay” is a specific charge that your health insurance plan may require that you pay for a specific medical service or supply. For example, your health insurance plan may require a $15 co-payment for an office visit or brand-name prescription drug, after which the insurance company will pay the remainder of the charges.