What is the Difference Between Coinsurance and Deductible?

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The main difference between coinsurance and deductible lies in their definitions and how they are applied in health insurance coverage:

Deductible:

  • A deductible is a set amount you pay for health care services before your health plan kicks in.
  • It is the portion of the medical cost you pay before your insurance starts covering the expenses.
  • For example, if you have a $3,000 deductible, you need to pay $3,000 before your insurance starts covering your medical expenses.

Coinsurance:

  • Coinsurance is a portion of the medical cost you pay after your deductible has been met.
  • It is the percentage of covered medical expenses you pay after you've met your deductible.
  • For example, if you have a 20% coinsurance, you will be responsible for 20% of the cost of your covered medical services.

In summary, a deductible is a fixed amount you need to pay before your health plan starts covering your medical expenses, while coinsurance is a percentage of the medical cost you pay after your deductible has been met. Both deductibles and coinsurance are ways health insurance plans share the cost of healthcare with policyholders.

Comparative Table: Coinsurance vs Deductible

Here is a table comparing the differences between coinsurance and deductible:

Parameter Deductible Coinsurance
Meaning A fixed amount the policyholder has to pay at the time of making a claim. A fixed percentage of the claim amount the policyholder needs to pay over and