1. 15786 POINTS
    Bob VineyardPRO
    Founder, Georgia Medicare Plans, Atlanta,GA
    Coinsurance is a funny sounding word that makes sense once you understand it.

    With most policies, coinsurance follows satisfaction of your major medical deductible. After the deductible, you pay a percentage of the approved claim and the carrier pays another percentage.

    In most situations the carrier pays 80% while you pay 20%.

    Coinsurance.

    You insure (or pay) and the carrier co-insures the claim.
    Answered on May 15, 2013
  2. 11783 POINTS
    Larry GilmorePRO
    Agent Owner, Gilmore Insurance Services, Marysville, Washington State
    Coinsurance represents the split between insurance company and the insured for a part of the costs incurred. Usually the deductible is met first. The deductible is the part of the bill that the insured pays for themselves. Then coinsurance kicks in where the bill is split between the insurance company and the insured. You will find 90/10,80/20,70/30,60/40 and 50/50 splits. The first number in say 80/20 represents the insurance company's part (in this case 80%) and the insureds part (20%) of the bill, until a maximum out of pocket is reached by the insured. Once the out of pocket costs are reached, the coinsurance is replaced for the balance of the year by full coverage on claims.
    Answered on January 27, 2018
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