More about Coinsurance versus Copays
Many
insurance plans today use a combination of coinsurance and copays. The more
routine services and treatments often use copays; whereas the more expensive
and/or less standard services typically use coinsurance. Sometimes prescription drug coverage uses the
greater of a copay and coinsurance. For example, a generic prescription may
cost you $20; but a brand-named prescription may cost $40 or 40% of the price,
which ever amount is greater. Finally,
some high-deductible plans – particularly those associated with Health Savings
Accounts (HSAs) – may not require either copays or coinsurance; instead the
insurance plan may simply pay 100% of the cost of covered services after the
high deductible is met. (After you finish
this article, you can learn more about Health Savings Accounts by clicking on the
HSA button in the left menu bar.)
Choosing
between a Copay plan and a Coinsurance plan may simply come down to personal
preference. Financial comparisons
between these types of plans are often hard to rely on because they depend
largely on individual utilization of specific services.