What does coinsurance refer to in health insurance?

Coinsurance is a form of cost-sharing in health insurance where the insured pays a certain percentage of the healthcare costs after the deductible has been met. This means that after the insured has paid their deductible, they are responsible for a specific percentage of the remaining medical expenses, while the insurance company pays the rest. For instance, if a plan has a coinsurance rate of 20%, the insurer covers 80% of the costs of a covered service, and the insured pays the remaining 20%. This structure helps to manage costs for both the insurer and the insured, encouraging individuals to consider the costs of the services they utilize.

The other definitions do not encapsulate the concept of coinsurance. The set dollar amount for each service refers more to copayments, not coinsurance. An additional fee for out-of-network providers pertains to the provider's network status and does not directly relate to the coinsurance concept. Lastly, the total amount of money paid by the insurer reflects the overall insurance payout, rather than the specific cost-sharing aspect inherent in the definition of coinsurance.