Glossary Term

Coinsurance

Coinsurance refers to an out-of-pocket expense paid by the patient for medical care covered under a health plan. In a coinsurance arrangement, the out-of-pocket fee is a percentage of the total cost of the medical service. For example, if a health plan charges a coinsurance fee of 30 percent for an x-ray and the total cost x-ray is $100, then the patient would pay $30 of that cost.

A common consumer frustration with coinsurance is the lack of transparency associated with the total cost of a medical procedure or treatment. Health care providers may not adequately disclose a procedure cost or may be hesitant to give a precise estimate because of variables that may not be discovered outside the performance of a procedure (e.g. surgery).


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