1. What is a Copay
A Co-pay is your portion of the bill after the deductible has been meet. In most cases you will have a $25 co-pay to see your primary doctor and if it is a specialist it maybe higher such as 40 or even 50.
2.What is Coinsurance
Most people are familiar and know what a co-pay is, but what about coinsurance?
Coinsurance is similar as to co-pay. Basically It’s your portion of a medical bill after your main deductible has been meet.
The difference between the two is that coinsurance is a percentage such as 90/10 or 80/20 while a co-pay is a fixed amount such as $25
What do these number mean? It’s very simple these numbers mean you pay for 10 percent or 20 percent of the bill after your deductible has been meet
After that your insurance company will pick up the tab for the rest of the approved amount up to the OOP or out of pocket maximum
3. What does Maximum out-of-pocket or OOP mean?
The Maximum out-of-pocket annual spending means that once you have paid a certain amount for the year, your insurance company will begin paying 100 percent for all covered services.
One important thing to look out for when looking at the OOP or out of pocket maximum is that if your making a claim on an “out-of-network” you will most likely be paying a complete separate OOP and deductible
so be careful to stay inside your network so you’re not paying 2 deductibles. This could get very expensive.
What to know how much health insurance costs in Utah? enter your zipcode below to find out.