Which statement best differentiates a co-pay from coinsurance?

• A. A co-pay is the fixed payment after the deductible; coinsurance is the fixed payment per visit.
• B. A co-pay is the fixed payment collected at the time of visit; coinsurance is the percentage of costs after deductible.
• C. A co-pay is the fixed payment collected at the time of visit; coinsurance is the fixed payment per visit.
• D. There is no difference between a co-pay and coinsurance.

Answer: (C)

In health coverage, a co-pay is a fixed amount you pay at the time of the service, such as a set dollar amount for a doctor visit or prescription. Coinsurance, on the other hand, is the share of costs you pay after you’ve met your deductible—the cost is a percentage of the allowed charges, not a fixed dollar amount. So you pay a predictable fee upfront with a co-pay, but coinsurance depends on how expensive the service is and is calculated as a portion of the total cost after the deductible has been met. The statements that describe coinsurance as a fixed per-visit charge or that there’s no difference between the two aren’t aligned with how most plans work.