Your plan may not have coinsurance; check your brochure. Coinsurance is the percentage of your medical costs that you must pay after reaching your deductible. When you incur health care costs from a medical provider/procedure, you must pay out of pocket until you spend a certain amount, known as your deductible. Once you have paid your deductible, your insurance company starts splitting the cost of future care, based on a set percentage of the costs. The percentage that you pay is your coinsurance (10%). IMG will pay 90% of your coinsurance and you will pay 10%.
Coinsurance is different from a copay, which is a flat fee you pay anytime you get certain types of health care services.
As an example, let’s say you go to the hospital and get a bill of $4,000 to have a minor surgery. You’ll need to pay your $350.00 per injury/per illness deductible, then, the 10% co insurance for that surgery.
The balance after the deductible is $3,650.00. You will need to pay 10% of that before the insurance company pays. 10% of that is $365.00 that you will owe to the provider.