Coinsurance

What does Coinsurance mean on a medical bill?

Coinsurance is your share of a covered service written as a share of the allowed amount instead of a flat fee. It normally kicks in after your deductible is met and runs until you reach your out-of-pocket maximum. Because it is figured from the allowed amount, the discount your plan negotiated shrinks your share along with the plan's payment. That is why a bill that ignores the discount and asks for a share of the full charge is worth stopping on before you pay it.

What does Coinsurance usually cost?

Your share is figured from the allowed amount on the EOB, not from the charge on the provider's bill. Out-of-network coinsurance is usually a bigger share of a bigger allowed amount, so identical care can land very differently.

What should I watch out for with Coinsurance?

• A bill that figures your share from the full charge instead of the allowed amount on the EOB
• Coinsurance billed before your deductible was met — ask the plan how the claim was applied
• A share still billed after the EOB shows you reached the out-of-pocket maximum