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What is co-insurance?

Dr. Michael Roizen, MD
Internal Medicine

Some health insurance companies have co-insurance, which is a set percentage (usually around 20%, but no more than 50%) of medical costs that you must pay after you’ve reached your deductible, but before you’ve reached your out-of-pocket max. Your insurance will cover the rest of the bill for your medical costs until you reach your out-of-pocket max.

Each co-insurance policy is unique, as are the percentages. Percentages can even vary based on the type of service you receive. To find out about your specific policy’s rules on co-insurance, whip out a magnifying glass and read your Summary Plan Description (SPD). You can also call your insurer or benefits office directly…we hope you don’t have to stay on hold for too long.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.