Copay vs. Coinsurance
Let's Make It Clear.
A friendly mini-lesson that takes the confusion out of these two tricky terms.
Copay
Coinsurance
Here's the Quick Version
A copay is a fixed amount you pay when you get care. A coinsurance is a percentage of
the bill you pay after you've met your deductible.
Copay
A fixed dollar amount you pay for specific services
Coinsurance
A percentage of the bill you share after meeting your deductible
Real-World Example
$25
Copay Example
Your copay might be $25 for a doctor visit, flat and simple.
20%
Coinsurance Example
Your coinsurance might be 20% of a larger bill, like $200 of a $1,000 MRI.
Why It Matters
Copays keep things predictable. Coinsurance varies, but it can help
more after your deductible is met.
Predictable
Fixed copays help you budget
Shared
Coinsurance splits larger costs
Pro Tip
When comparing plans, look at how your most common care, like doctor visits or prescriptions, is billed. Copay or coinsurance? That detail can change everything.
A quick peek can save hundreds.
The Bottom Line
Copay = fixed price. Coinsurance = percentage. Both help you and your plan share costs fairly.