What is co-insurance?

• A. The fixed fee per visit.
• B. The fixed payment collected at the time of service.
• C. The amount you will pay for services after the deductible is met but before you have reached your maximum out-of-pocket amount.
• D. The total cost of all services in a year.

Answer: (C)

Co-insurance is the portion of costs you pay for covered services after you’ve met your deductible. It’s usually a percentage—such as 20%—with the remaining 80% covered by the insurer, continuing until you reach your out-of-pocket maximum. After hitting that maximum, the plan pays 100% of covered costs for the rest of the year. Before the deductible is met, you typically pay the full amount you’re charged (unless your plan uses separate copays). This differs from a fixed per-visit payment (a copay) and from the total annual cost, which is the overall amount your care costs in a year.