Which is Better? A Co-Pay or a Co-Insurance? The HealthyMarks Education Series

July 15, 2019

Welcome back to the HealthyMarks Education Series. What is a Co-Pay? What is a Co-Insurance? Which is better? You may be thinking "I have no idea what the difference is." And that’s okay. As simple as it gets a co-pay is a dollar amount and the coinsurance is a percentage. So I may go to my primary care physician and have a co-pay of $20. I may then go have an x-ray and have a coinsurance of 30%.

So which is better? A Co-Pay.

 

Reason one: it’s a much simpler calculation to understand what you will be paying out of your own pocket. $20 dollars is going to $20 and you can expect to pay that every time you see your primary care physician. Coinsurance can be a trickier one. Which is better I $700 co-pay in hospital overnight stay, or a 30% coinsurance? A co-pay is almost always got to be less expensive in these scenarios and you know exactly what you’re paying.

 

Here is scenario 2: I visit to doctor for my knee surgery. Dr. A says it will cost $3000. Dr. B says it will cost $4000… but I liked Dr. B a lot more. With a copay of $900, I’ll pay $900 no matter which doctor I see. IF I had a co-insurance of 30%, I’d pay $900 for Dr. A but $1200 for Dr. B… A co pay is better. So the next time you get your insurance and the services covered take a look and see if there’s a lot of percentages or a lot of dollar amounts next to your portion of the costs. A good sign of a bad insurance plan is one with a lot of coinsurance instead of co pays.

 

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