What is co-insurance?

Co-insurance is the sharing of costs between an insurance provider and the insured (a person who has health insurance). Typically, an insurance provider will cover a large portion of the costs of the medical care, but the insured will have to pay the remainder. This remainder is called co-insurance. For example, an insurance provider might cover 80% of a medical bill, but the insured would be responsible for the other 20%. Generally, the insured pays the co-insurance at the time of service and the insurance provider pays their share directly to the medical provider. In Virginia, health insurance law requires that all health insurance plans must cover a minimum Essential Health Benefit package. This includes a set of basic benefits such as physician services, hospital care, emergency services, and preventive care. Many plans also have co-insurance requirements. For example, a plan might require co-insurance for certain services, such as hospital stays, specialist visits, or lab tests. This means an insured person will have to pay a percentage of the costs associated with those services. Co-insurance helps to reduce the overall cost of health care for both the insured and the insurance provider. It encourages the insured to be more cost-conscious when seeking medical care and, at the same time, it helps to protect the insurance provider from having to pay the full cost of the medical services.

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What is co-insurance?

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