Coinsurance, copay and deductible information
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How deductibles and coinsurance work
All of our plans involve either one or both of two important features: deductibles and coinsurance. Knowing how these work can help you better understand how health insurance works.
- You pay the full amount of your health care costs until you reach your deductible.
- Once you've reached your deductible, BCBSKS shares your health care costs with you. This is known as coinsurance. The percentage you pay can range from 20-50%, depending on the plan you pick.
- Coinsurance has a maximum. Once that coinsurance maximum is met, BCBSKS pays 100% of your covered health care costs for the rest of the year (except for copayments, which you'll still have to pay).
|
1. Deductible |
2. Coinsurance |
3. Full coverage |
|
|---|---|---|---|
|
You Pay |
100% |
50% or 20% |
0% |
|
BCBSKS Pays |
0% |
50% or 80% |
100% |
Figures are for illustrative purposes only. The examples provided in the chart relate to in-network service only. When using out-of network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSKS allowed amount and the provider's actual charge.