How is co-insurance calculated?

• A. As a flat fee regardless of charge
• B. As a percentage of a charge
• C. Based on the total revenue
• D. As a fixed monthly amount

Answer: (B)

Co-insurance is calculated as a percentage of the total charges for a healthcare service. This means that after the deductible has been met, the insured person will pay a specified percentage of the remaining costs, while the insurance company pays the rest. For example, if the co-insurance rate is set at 20%, the insured will be responsible for paying 20% of the eligible medical expenses after the deductible, with the insurance covering the remaining 80%.

This method of calculation reflects how co-insurance works within many health insurance plans, incentivizing patients to share in the cost of their healthcare while still being financially protected to some extent. Understanding this percentage-based approach is crucial for navigating insurance coverage and determining out-of-pocket costs for medical services.