What is the definition of coinsurance?

Study for the Anthem Medicare Advantage Certification Exam. Prepare with flashcards and multiple choice questions, each question includes hints and explanations. Get exam ready!

Coinsurance is defined as a percentage of the cost of services that a policyholder is required to pay after meeting their deductible. This means that once the deductible has been paid, the insured person is responsible for a specific percentage of costs for medical services received, while the insurance company covers the remaining percentage. For example, if a health insurance plan has a coinsurance rate of 20%, the policyholder would pay 20% of the costs for treatments or services, and the insurer would cover the remaining 80%.

This mechanism differs from a fixed amount paid for services, which would be a copayment, and does not encompass the total amount owed for care, which includes all out-of-pocket expenses such as deductible, copayments, and coinsurance. It's also not a definition that covers all costs being paid by insurance, as coinsurance specifically pertains to shared costs between the insurer and the insured.

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