So What The Heck Does Coinsurance Mean?

[mommy794 119]

I have worked in the medical field for 24 yrs and I don't even know what exactly this means as far as what my out of pocket will end up being. I have a primary and secondary both 2 different forms of bcbs Tx We are still working on whats what but maybe someone who has dealt with the coinsurance aspect will fill me in thanks!

[circa 333]

Coinsurance is the amount of the procedure or bill that you accept the responsibility for. Its the most ridiculous word used in the insurance industry. Its not really any different than a copay, other than its usually a percentage, rather than a set amount. So if your insurance covers 80%, you have a 20% coinsurance that you're responsible for paying. If you're double covered, you would probably have a very minute amount to pay if anything. One more thing - as far as coinsurance is concerned, it cannot exceed your "out of pocket maximum" So if you have a $2000.00 out of pocket maximum on your policy, even if your 20% of the bill comes to more than that, you won't have to pay any more than the $2000.00

[Was a humpty dumpty 35]

My Kaiser policy changed to a DHMO just before my surgery, I had to pay a 10% coinsurance. Which my cost was 2 thousand.

[mommy794 119]

NOW I understand, thank goodness yall can fill me in! Thanks so much! I talked to my surgeon today and he reassured me that my OOP was not going to be some extrodinary amount... I was so relieved!!! Insurance is a nitemare to understand even for us medical folks. I can not imagine how ppl who have no knowlege of how it all works FEEL and how confusing and frustrating it would be... wow