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Employer Benefits IQ
Plan Design

Coinsurance

The percentage of costs a member pays after meeting their deductible.

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Full Definition

Coinsurance is the percentage of covered healthcare costs that a plan member pays after meeting their deductible. For example, with 20% coinsurance, the member pays 20% of covered costs and the plan pays 80%, until the out-of-pocket maximum is reached. Coinsurance applies to most medical services and is distinct from copays, which are fixed dollar amounts.