Coinsurance is the percentage of a claim you are required to pay after you meet your deductible. The
remainder of the claim is paid by your benefit plan, up to the annual maximum.
- The percentage of a claim that an employee owes as coinsurance varies based on the type
- A pre-treatment estimate will let you know how much your coinsurance will be for a claim
that is a little more complex.
Coinsurance is most often a part of the dental benefit. Coinsurance is can sometimes be confused with
How it works
- Chris has already met their deductible for the benefit period and receives a crown.
- A crown is considered a major procedure and is covered at 50% by the plan benefit.
- Chris will pay 50% coinsurance out-of-pocket costs for the cost of the crown, and the plan benefit will cover the other 50%.