Cost Sharing

Common insurance terms explained

August 26, 2013 Ryan Schuster

Health insurance terms can be confusing.

What's the difference between a copayment and coinsurance? Find out with these brief descriptions of often misunderstood health insurance terms:

  • DEDUCTIBLE – The predetermined amount (spelled out in your specific health plan) that you need to pay before your health insurance kicks in (many auto insurance plan also have deductibles that must be met before coverage begins).
  • COINSURANCE – The percentage of covered services you are responsible for after your deductible has been met.
  • COPAYMENT – A dollar amount you may be required to pay each time you visit the doctor.
  • COST SHARE – The total amount you are responsible for paying when receiving covered health care services. The total cost share amount includes the deductible, coinsurance, copayments and non-formulary prescription sanctions.

Here is an expanded list with more definitions of health insurance terms on our website.