| URL | Description |
|---|---|
| Co-insurance | This provides a definition of Co-insurance so we understand one of the restrictions concerning the "grandfathered status" of insurance plans. In health insurance, coinsurance is sometimes used synonymously with copayment,[1] but copayment is really fixed while the coinsurance is a percentage that the insurer pays after the insurance policy's deductible is exceeded up to the policy's stop loss.[2] It is expressed as a pair of percentages with the insurer's portion stated first. The maximum percentage the insured will be responsible for is generally no more than 50%. Once the insured's out-of-pocket expenses equal the stop loss the insurer will assume responsibility for 100% of any additional costs. 70-30, 80-20, and 90-10 insurer-insured coinsurance schemes are common, with stop loss limits of $1,000 to $3,000 after which the insurer covers all expenses.[3] |