What does the term "coinsurance" refer to?

Study for the Pharmacy Billing and Reimbursement Test. Engage with interactive questions and detailed explanations. Prepare effectively with targeted learning resources and ensure your success!

Coinsurance refers to the percentage of healthcare costs that a patient is responsible for paying after they have met their deductible. This term is commonly used in insurance policies where the patient shares a portion of the costs for covered services alongside their insurance provider.

In practical terms, once an individual has fulfilled their deductible requirement, the insurance plan starts to cover a certain percentage of their medical expenses, while the patient pays the remaining percentage. For example, if a patient's coinsurance is set at 20%, and they incur a medical expense of $100 after meeting the deductible, they would be responsible for paying $20, and the insurance company would cover the remaining $80.

Understanding coinsurance is crucial for patients as it can significantly affect out-of-pocket costs for medical care and prescription medications.

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