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Three Categories Of Out-Of-Pocket Payments

When it comes to the different types of health insurance coverage there are certain out of pocket expenses that one can expect depending on the type of policy they choose. For most policies and coverage types there are three basic out of pocket expenses that can be expected. They are:

The Copayment:
A "co-payment" or "co-pay" is a specific charge that your health insurance plan may require that you pay for a specific medical service or supply. For example, your policy may require a $15 co-payment for an office visit or brand-name prescription drug, after which the insurance company often pays the remainder of the charges.

The Deductable:
A "deductible" is a specific dollar amount that your plan may require that you pay out-of-pocket each year before your coverage begins to make payments for claims. Not all health insurance plans require a deductible. As a general rule (though there are many exceptions), HMO plans typically do not require a deductible, while most Indemnity and PPO plans do.

The Coinsurance:
Coinsurance is the term used by health insurance companies to refer to the amount that you are required to pay for a medical claim, apart from any co-payments or deductible. For example, if your policy has a 20% coinsurance requirement (and does not have any additional co-payment or deductible requirements), then a $100 medical bill would cost you $20, and the plan would pay the remaining $80.

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