What is a coinsurance cap?

A coinsurance cap is a limit on the amount of coinsurance a health insurance plan will cover for certain services. Coinsurance is the percentage of the cost of a medical service that an insured patient pays out of pocket. In North Carolina, most health insurance plans have a coinsurance cap of 50%. This means that the patient will pay no more than 50% of the cost of a medical service, after deductibles have been met, and the health insurance plan will cover the remainder. This protection is especially important for those who require expensive treatments or procedures, as it caps the amount they have to pay out of pocket. It also helps to protect families from financial hardship by limiting their financial responsibility in the event of a medical emergency.

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