Health Insurance Chicago Illinois IL
Reader’s Question:
I would like to be perfectly clear about the differences between a deductible and coinsurance as these terms relate to my health insurance. Please explain. Thanks for your help for I don’t know much about health insurance in Chicago IL!
Wagner
Chicago, IL
Good day Wagner,
This is an important question. Health insurance deductibles and coinsurance are often misunderstood terms. Let’s see if we can clarify them for you.
A health insurance deductible is a defined amount that a subscriber must pay before his health insurance takes over. Take your prescription plan for example. Most health insurance policies in Chicago Illinois IL require the subscriber to pay an annual amount for prescriptions before their exposure begins. Therefore you will pay that amount when you make your first prescription purchases each year. When you have paid your full family or individual deductible for prescriptions, your health insurance carrier will pay the rest. Health insurance deductibles apply to individuals and families. You should review these amounts each year.
Many health insurance plans in Chicago Illinois utilize a coinsurance formula. This is generally an established percentage that determines the exposure for the subscriber and the carrier in Chicago IL. In the most common coinsurance formula, the subscriber pays 20% of a covered service and the health insurance carrier pays 80%. This formula is called 80 percent coinsurance. Other derivatives of this formula are available. Hope this clarifies these health insurance terms for you, Wagner. Take care in Chicago.
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