- What is the difference between a 'copay' and 'coinsurance'?
Copay: A copay is usually a flat fee. For example, every time you go to the doctor you pay a $25.00 copay for the office visit, regardless of the level of service you receive. This amount is due at the time of the visit.
Coinsurance: Coinsurance is a term used for a percentage amount you are responsible for. For example, if your insurance policy is '80/20', then the insurance pays 80%, and you are responsible for the remaining 20% of the charges. This 20% is called 'coinsurance'. The amount can vary as the cost of the services performed varies. You will receive a bill for your portion once the service charges have been sent to the insurance company.
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