What is the difference between a copay and coinsurance?

A copay is a flat fee you pay for specific medical services – usually doctor visits or prescription drugs – often regardless of whether you have hit your deductible. Copays are shown as a dollar amount. For example, "$10 copay per visit" or "$5 copay for generic medications." For MDLIVE visits, your copay, if any, will be displayed before your visit starts.

Many High Deductible Health Plans (HDHP) use coinsurance instead of copays for doctor visits. Coinsurance is the portion of covered medical expenses you can expect to pay out-of-pocket after you have hit your deductible. Your insurance plan pays the remainder of the bill. Coinsurance is shown as a percentage. For example, if you have reached your deductible and have 20% coinsurance, you would pay $10 out-of-pocket for a visit that costs $50.

If you have a medical or mental health emergency, call 911.

Seek immediate medical attention if you experience a life-threatening condition or acute or severe symptoms.


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