When both you and your health insurance company pay part of your medical expense, it’s called cost sharing. Deductibles, co-insurance and co-pays are all examples.
Understanding how they work will help you know when and how much you have to pay for your treatments.
A deductible is the amount you pay for health care services before your health insurance begins to pay.
Let's say your plan has a $1500 deductible. That means for most services, you'll pay
100% of your medical bills until the amount you pay reaches $1500. After that, you share
the cost with your plan by paying co-insurance and/or co-pays.
Co-insurance is your share of the costs of a service. It's usually a percentage of
the allowed amount. You start paying co-insurance after you've satisfied your
Here's how it works; Lisa is receiving massage therapy and she has paid her $1500
deductible. Now her plan will cover 70% of the cost of her treatments. Lisa pays the
other 30%; that's her co-insurance. If her treatment costs $150, her plan will pay $105
and she'll pay $45. Please be aware that these amounts may vary from company to company.
A co-pay is a fixed amount you pay, usually at the time of service. The amount
can vary based on the type of service.
For example, your acupuncture treatment might require a $30 co-pay. For some
services, you may have both a co-pay and co-insurance.
I recommend contacting your insurance company to confirm your coverage and responsibility. If you still have questions, feel free to contact me.