Ace Your Pharma Billing & Reimbursement Exam 2026 – Unlock Your Prescription Power!

Coinsurance refers to the percentage of healthcare costs that a patient is responsible for paying after they have met their deductible. This term is commonly used in insurance policies where the patient shares a portion of the costs for covered services alongside their insurance provider.

In practical terms, once an individual has fulfilled their deductible requirement, the insurance plan starts to cover a certain percentage of their medical expenses, while the patient pays the remaining percentage. For example, if a patient's coinsurance is set at 20%, and they incur a medical expense of $100 after meeting the deductible, they would be responsible for paying $20, and the insurance company would cover the remaining $80.

Understanding coinsurance is crucial for patients as it can significantly affect out-of-pocket costs for medical care and prescription medications.