Understanding Co-Insurance With A Health Plan

What Is Co-Insurance?

Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.

A “deductible“ is an amount you pay before the Insurance Company starts paying (plans will have different “deductibles” $250, $500, $2,000 etc., so read your plan). Think of it like 1st base in a game of baseball. Once you’ve paid all of your deductible, you are standing on 1st base. Now you’ll begin to move towards 2nd base – “Co-insurance”. During this time, co-insurance is where you and the insurance company split the medical bills, for example 70/30 or 80/20. Usually the insurance company will pay the larger amount and you pay the lesser amount.

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Understanding Co-insurance With A Health Plan

Your next step is 3rd base or your “Out of Pocket Maximum”. This is the maximum YOU have to pay in a year, not the insurance company. Once you’ve met your “out of pocket maximum”, you will no longer have to pay for any future medical services. The insurance company will pick you up on 3rd base, and carry you to home plate.

Note: This is an annual accrual, meaning it starts January 1st and ends December 31st each year.

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Getting Co-Insurance From Nevada Insurance Enrollment

Navigating through the many options of insurance can be confusing and chaotic, but speaking with a locally licensed insurance agent will help you to obtain the right coverage you need. You’ll have the peace of mind knowing that you are adequately insured when life complications arise. We work hard to find the most competitive quotes for your needs. Contact us today to begin the process of finding the best insurance plan for your family.

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