Important Insurance Terms - Deductibles, Copays & Coinsurance

• What is a Deductible

For a covered medical expense, the deductible is the portion of your medical bill that is your responsibility. The deductible will first be subtracted from the total medical bill and

you will need to pay this portion directly to the doctor or hospital.

• A “Per Illness or Injury Deductible", means if you have to go to the doctor more than once for the same illness or injury, you will only need to pay the deductible one time. You will need to pay the Deductible again, for any additional illnesses or injuries.
  

• An "Annual Deductible", means you only pay the Deductible one time per policy year.
  

• What is a Copayment

A copayment is a fixed amount you pay for medical services. The copayment are per visit and are collected by the doctor's office or medical facility at the time of your visit. Some policies have a $25 - $50 copayment for going to the doctor or Urgent Care. Emergency Room visits may have a higher copayment ($100 - $500) if you are not admitted into the hospital. Be sure to double check your policy!

• What is coinsurance?

Coinsurance is the share of medical costs you are responsible for paying after you have met your deductible. It is usually shown as a percentage (%) in your policy.

• 100% coinsurance: The insurance company pays 100% of covered medical expenses after your deductible and copayments.

• 90% coinsurance: The insurance company pays 90%, and you pay the remaining 10% after your deductible and copayments.

• 80% coinsurance: The insurance company pays 80%, and you pay the remaining 20% after your deductible and copayments.

In short, coinsurance tells you how much the insurance company pays versus how much you pay once your deductible has been met.

Questions about your deductible, copayments or coinsurance? Contact VISIT® Insurance at 703-660-9062 or info@visitinsurance.com and we will be happy to review your policy details with you.