This is an insurance policy where the owner and insurance company share the risk.

What plan members are expected to pay toward the cost of covered health expenses, most often after the deductible is met, usually determined as a percentage of the total cost.

The percent of the Medicare-approved amount that you have to pay after you pay the deductible for Part Aand or Part B. In the Original Medicare Plan, the coinsurance payment is a percentage of the approved amount for the service (like 20%)

An insurance policy provision under which the insurer and the insured share costs incurred after the deductible is met, according to a specific formula. Or more generally, a sharing of risk between the insurer and the insured. also called copay.

A condition in a property insurance policy that requires an Insured to pay a part of the loss if the amount of insurance carried on the property is less than a specified percentage of the property value.

The amount, usually 20% of Medicare allowed charges, that are not reimbursed by the Medicare program.

The percentage of the allowed amount that is the member responsibility to pay after meeting a deductible.

A term used to describe the enrollee's share of cost. The insurer pays a fixed percentage of the enrollee's medical expenses, and the enrollee pays the balance.

the percentage of the covered expenses which must be paid by the member.

A method of reinsurance under which the assuming company receives a proportionate share of all of the risks and cash flows of the policy. (One typical exception may be the policy fee, which remains with the ceding company.) The reinsurer receives its share of the premiums and benefits, and sets up its share of the reserves. Typically, the reinsurer pays an allowance to the ceding company to represent the reinsurer's share of the acquisition and maintenance expenses.

The provision in insurance coverages in which the insured and the insurer agree to share in the covered losses in the proportion specified in policy terms and conditions. 1) In property insurance, the policyholder must carry an amount of insurance that is at least equal to a set percentage of the value of the property in order to receive full payment of a loss. 2) In health insurance, it is the portion, normally based either on a flat dollar amount or a percentage, of each claim not covered by the insurer. Coinsurance normally applies to the amount in excess of any deductible.

Your share of the cost for covered medical expenses after you've met your deductible and after the health plan pays their portion. For example, under Tier II of the 3-Choice Health Plan, the plan typically pays 75% of allowable costs and you pay 25% -as your coinsurance-after you've met your deductible.

a provision of a dental benefit program by which the beneficiary shares in the cost of covered services, generally on a percentage basis. The percentage of a covered dental expense that a beneficiary must pay (after the deductible is paid). A typical coinsurance arrangement is one in which the third party pays 80% of the allowed benefit of the covered dental service and the beneficiary pays the remainder of the charged fee. Percentages vary and may apply to table of allowance plans; usual, customary, and reasonable plans; and direct reimbursement programs.

The amount shared by the insured and the insurer. For example: PPO (90%), Non-PPO (70%), the insurer (carrier) pays 90%, the insured (individual) pays 10% for PPO covered services. Or, the insurer pays 70% and the insured 30% for Non-PPO covered services.

The percentage of the Medicare payment rate or a hospital's billed charge that you have to pay after you pay the deductible for Medicare Part B services.

The percentage of a provider’s fee that the patient is expected to pay. For example, many traditional insurance companies pay 80% of a physician’s usual, customary and reasonable (UCR) fees. The patient is expected to pay the 20% difference between the physician’s UCR fees and what the insurance company pays. The 20% which the patient pays is called the coinsurance.

a provision in a member’s coverage that limits the amount of coverage by the plan to a certain percentage, commonly 80 percent. Any additional costs are paid out of pocket by the member.

the portion of eligible expenses that is payable by the Participant. *Once any deductible amount and coinsurance are paid, the insurer is responsible for the rest of the reimbursement for covered benefits up to allowed charges: the individual could also be responsible for any charges in excess of what the insurer determines to be "usual, customary and reasonable". * Coinsurance rates may differ if services are received from an approved provider (i.e., a provider with whom the insurer has a contract or an agreement specifying payment levels and other contract requirements) or if received by providers not on the approved list. * In addition to overall coinsurance rates, rates may also differ for different types of services.

A way of relatively splitting the risk between the insured party and the insurance provider.Coinsurance depends in large part on the value of the insured property and the amount specified in the insurance policy.Coinsurance only applies to situations where there is only a partial property loss or partial damage.

The amount that you are required to pay for a medical claim, apart from any co-payments or deductible.

Those medical expenses covered on a shared basis between the insured and the insurance company or health plan usually expressed as a percentage as in 20%/80% where the insured pays a 20% share and the insurance company pays an 80% share.

The portion or percentage of each Medicare approved amount a Medicare beneficiary must pay after they have paid the deductible.

The portion of the cost for covered services which is the responsibility of the subscriber. In most cases the benefit program will pay 80% and the subscriber is responsible for 20% of the allowance for any given service. This arrangement is after any applicable deductible amount is met.

A shared portion of medical and hospitalization expenses, after deductible is met. Described as a percentage (e.g., 80%;20%).

the shared financial responsibility for services covered by the health plan.

The dollar amount or percentage you pay. For example, if you have an "80/20 plan," your health plan would pay 80% of the bill and you would pay 20%. The 20% you pay is your coinsurance.

A cost-sharing requirement under a health insurance policy that requires the patient to pay a percentage of costs for covered services/prescriptions (e.g., 20% of the prescription price).

A type of insurance where the insured agrees to carry a specified proportion of the policy amount to the actual value of the property insured at the time of loss. Thus, a portion of the property value is self insured. In federal multi-family housing pro-grams, it refers to a sharing of the risk of mortgage default between a mortgage firm and the federal government.

The portion of the bill for a medical service, within allowable payment limits, that is not covered by the patient's health insurance policy and therefore must be paid out of pocket by the patient. (Coinsurance refers to a percentage, e.g., 10 percent of the total charge; copayments are stated as flat amounts, e.g., $5 per office visit.)

Most building and business personal property policies have a coinsurance clause which requires the insured to carry insurance equal to at least a specified percentage of the actual cash value of the property. If a loss occurs and it is determined that the amount of insurance carried is less than the amount required, a penalty could be placed on the insured. Back to list of terms.

A health insurance principle under which the company insures only part of the potential loss, with the insured paying the other part. For instance, in a major medical policy, the company may agree to pay 75 percent of the insured's expenses, the insured to pay the other 25 percent. Most commonly used as synonymous with risk-sharing or loss-sharing. The coinsurance provision states that the insurance company and the policyowner will share covered losses.

Insurance in which more than one insurer shares a part of a single risk. Insurance with another of a risk. Coinsurance is usually effected by separate contracts of insurance by separate companies, each of which undertakes a fractional part of the whole risk.

Requirement of an insurance policy or prepayment plan that a percentage of the provider's charges are paid by the covered employee/dependant.

Your percentage share of the cost of eligible expenses. For example, in the PPO plan options, the coinsurance arrangement is 90%/10%, in which case Northrop Grumman pays 90% of the usual, reasonable, and customary (URC) expenses and you pay 10%. You pay coinsurance after you meet the individual or family deductible.

A provision in a member's coverage that limits the amount of coverage by the plan to a certain percentage, commonly 80%. Any additional costs are paid by the member. This is characteristic of indemnity insurance plans and PPO plans. The coinsurance usually is about 20% of the cost of medical services after the deductible is paid.

The percentage of billed charges that you may have to pay after you pay any plan deductibles. The coinsurance payment is a percentage of the cost of the serv ice. For instance, your health plan might pay 70 percent of billed charges, and your coinsurance payment is the remaining 30 percent.

A percentage of the costs of services a patient pays. This is a characteristic of indemnity insurance, POS, and PPO plans.

Coinsurance is the percentage of a medical bill that an insured person must pay, after deductibles and/or co-pays are met. While coinsurance is commonly 20 percent, it can be as little as zero or as much as 50 percent (for out-of-network services, for example).

A percentage of the charges that you pay. Typically 20 percent.

A type of reinsurance plan in which the ceding company pays the reinsurer part of the premium paid by the insured, minus a proportionate share of the commission and premium taxes associated with the policy that is being reinsured and a portion of the ceding company's general overhead expenses.

Defines the amount of each loss that the company pays according to a formula. The indemnification of the insured for a property loss can never exceed (1) the dollar amount of the actual loss (2) the dollar limits of the insurance policy (3) the dollar amount determined the coinsurance relationship. The lesser of the above three amounts will always apply

a percentage of the cost for medical expenses, such as doctor's visits, that you are responsible to pay.

insurance issued jointly by two or more underwriters

A provision in insurance policies that requires the insured to share in the cost of covered services on a percentage basis. A typical coinsurance arrangement is 80% by the insurer and 20% by the insured.

Shared cost of covered services paid by the plan and the member. The coinsurance begins only after a member has met his/her deductible.

The amount, as determined under the terms of the applicable benefit agreement, that is the portion of the allowable expense for covered services that a member is required to pay to the participating provider rendering such services.

The insured and the insurer share the cost of the claim within a specified ratio. For example, the insurer pays 80%, the insured pays 20% of the claim expense.

A fixed percentage of the total amount paid for a health care service that can be charged to a beneficiary on a per service basis.

A relative division of risk between the insurer and insured, depending on relative amount of the policy and the actual value of the property insured. Takes effect only with partial loss, less than the amount of the policy coinsurance clauses induce the owner to carry full or nearly full coverage.

The percentage of a claim for products or services payable by Alberta Blue Cross (e.g. drugs could be covered at 80 per cent)

A cost sharing feature in which the Member pays a fixed percentage of the cost of medical care after the deductible has been satisfied. Coinsurance may also be defined as a Copayment.

The portion of covered health care costs, usually a fixed percentage, for which the covered person has a financial responsibility. Coinsurance usually applies after the insured meets his/her deductible.

means the percentage of Eligible Charges that must be paid by the Member for care and/or treatment after the Deductible has been met.

Coinsurance refers to money that an individual is required to pay for services, after a deductible has been paid. In some health care plans, coinsurance is called "co-payment." Coinsurance is often specified by a percentage. For example, the employee pays 20 percent toward the charges for a service and the employer or insurance company pays 80 percent.

The amount of the cost of care that the patient or covered individual is responsible for. This is usually determined by a fixed percentage, and often applies after a specific deductible has been met.

An arrangement under which the insured person pays a fixed percentage of the cost of medical care after the deductible has been paid. For example, a health plan might pay 80% of the allowable charge, with the enrollee responsible for the remaining 20%; the 20% amount is then referred to as the coinsurance amount.

Arrangement by which the insurer and the insured share, in a specific ratio, payment for losses covered by the policy, after the deductible is met.

The percentage of a charge the covered person must pay for a service

A type of a health insurance plan in which an insured person has to bear a stated percentage of medical expenses.

Coinsurance is the percentage of covered expenses paid by the patient each year after he/she meets his/her deductible. For example, 20 percent coinsurance means that the patient pays 20 percent of the expenses.

Coinsurance is the proportion of the cost of medical and dental care expenses that is payable by the insured, up to the amount of the maximum contribution.

The portion of covered claim costs the insured is financially responsible for, usually according to a fixed percentage. Coinsurance often is applies, according to a fixed percentage after a deductible requirement is met.

Some insurance coverage requires you to pay a percentage of the cost of covered medical services, usually 20-30 percent. For example, you pay 20 percent of the cost, and your insurance pays 80 percent of the cost. Your portion of the cost is the coinsurance.

The amount you are required by your insurance company to pay after you have met your deductible. The coinsurance rate is generally expressed as a percentage. Example: If the insurance company pays 75% of the claim. You pay 15%.

A provision stating that the insured and the insurer will share all losses covered by the policy in a proportion agreed upon in advance.

The portion of the cost for care received and for which an individual is financially responsible. Usually this is determined by a fixed percentage, as in major medical coverage. Often coinsurance applies after a specified deductible has been met.

Cost-sharing requirement that the insured pay a designated percentage of the allowed amount for covered services.

In property insurance, a coinsurance clause requires the policyholder to carry insurance equal to a specified percentage of the value of the property in order to receive full payment of a loss. In health insurance, coinsurance is a percentage of each claim, above the deductible, that is paid by the policyholder.

The amount the member pays for certain covered drugs. Coinsurance is a percentage of the actual drug cost. For Medi-CareFirst Rx drug plans, coinsurance is paid only for medical injectables until you reach $3,600 in out-of-pocket costs. After that, you may pay a coinsurance of 5% (or $2 for generic or $5 for brand-name drugs, whichever cost is greater)

The portion of medical expenses you must pay in addition to your co-payment. Coinsurance applies only to the PPO plan.

Coinsurance is the percentage of the allowed amount you are responsible to pay. For example, if your plan pays 80 percent of eligible expenses, you pay the remaining 20 percent.

The percent of the approved amount that the client pays after the deductible is paid.

The percentage you pay for your prescription drugs vs. the percentage the insurance pays

The amount (usually stated as a percentage; e.g., 20%) of a claim that an insured person is expected to pay out-of-pocket up to the stop-loss limit. A common split found on health insurance policies is that the policy pays 80% of expenses with the insured paying (i.e., coinsuring) the remaining 20%.

The amount you are required to pay for medical care after you satisfy the annual deductible, if any. It is usually expressed as a percentage of billed charges. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.

Policy condition that requires an insured to pay part of a loss if the amount of insurance carried on property is less than a specified percentage of the value of the property at the time of loss.

The percentage of covered charges you must pay after you have met your annual deductible.

(see also Copayment, Cost Sharing, Deductible): A cost-sharing feature that requires the insured party to assume a percentage of the costs of covered services, in addition to any deductible amounts.

The percent of the Medicare Eligible Expense that you have to pay after you pay the deductible for Part A and/or Part B.

Two or more policies of title insurance issued by different insurers, each covering a portion of the same risk, which together provide total coverage of the risk.

An insurance policy that allows the insurer and insured to share costs incurred after the deductible is met.

That percentage of the cost of care that an insured has to pay under the terms of some health care plans. (Related: Copayment and Deductible)

means the amount, expressed as a percentage, of a covered health care expense that is partially paid by the Plan and partially the Member's responsibility to pay. The cost-sharing responsibility ends for most covered services in a particular calendar year when the out-of-pocket maximum has been reached.

An arrangement whereby depositors are insured for a pre-specified portion, less than 100 percent of their deposits.

A common policy provision in medical insurance where the insured person and the insurer share the covered losses under a policy in a specified ratio, i.e., 80 percent by the insurer and 20 percent by the insured.

For Health Insurance, it is a percentage of each claim above the deductible paid by the policyholder. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. A predetermined percentage of the Eligible Charges for covered Services that a paricipant must pay directly to the provider for certain Health Care Services after the Deductible has been met within the Calendar year.

A provision in insurance policies that requires the participant to pay a percentage of all eligible medical expenses, in excess of the deductible.

Is a hedging or risk management term. It refers to the amount of loss that the investor is positioned to take. When a firm is 85 percent hedged, then it is said that the firm is coinsuring the remainder or 15 percent. When an individual holds 100 shares of stock priced at $80/share and is also long a put with a $75 strike price, the individual is said to be coinsuring for $500 or the difference between the market price and the exercise price.

A type of cost sharing where the insured party and insurer share payment of the approved charge for covered services in a specified ratio after payment of the deductible. Most fee-for-service plans require a 20 percent coinsurance for covered inpatient and outpatient medical/surgical services.

An amount or percentage that health plan members are required to pay for health care products or services in conjunction with their employers' benefits plans.

A percentage of allowable charges (usually an 80/20 split) for which the member is responsible after satisfying the deductible.

When more than one insurance company shares the risk of a particular transaction or series of transactions. Lenders may require co-insurance on large commercial projects.

A provision in a medical-expense insurance policy which requires that the insured person pay part of the expense and the insurance company will pay the remaining part. (Also see Coinsurance [Property Insurance].)

A provision in a property insurance policy which requires the insured to carry insurance equal to a certain specified percentage of the value of the property for the insured to receive full payment on a loss up to the amount of the policy. Otherwise, payment would be only a percentage of the actual loss, that percentage determined by the amount of insurance carried relative to the amount that is required to be carried by the policy for full protection up to policy limits. (Also see Coinsurance [Health Insurance].)

The percentage of each health care bill you must pay out of your own pocket, including any non-covered charges and deductibles. Usually does not apply to HMO coverage.

refers to the amount you are required to pay after you have met your deductible. Typically, coinsurance is specified by a percentage. For example, after your deductible has been met, you may be required to pay 30% of the cost of treatment while the insurance company pays 70%.

A member's share of the cost for covered services, paid to providers at the time care is received.

Co-insurance is the portion of your health-care expense not covered by insurance. A co-insurance is usually a percentage, like 10 percent or 20 percent. For example, on a $500 bill, your deductible might be $150, so you would have to pay the first $150. This leaves a balance of $350. Of the $350, your co-insurance might be 20 percent, meaning you will have to pay an additional $70. Your insurance will pay the remaining $280.

The percentage of an eligible expense that must be paid by the covered person. Coinsurance is calculated upon the allowed amount, not the billed amount.

This may refer to either of the following situations: (a) Where two or more insurers underwrite the same risk with several liability such that each insurer is not bound to follow the decisions of any co-insurer unless it has agreed to do so. (b) Where the insured acts as its own insurer for a specified proportion of the sum insured.

The portion of the cost of care you are required to pay after your health plan pays. Usually, it is a percentage of an approved amount. In Original Medicare the coinsurance is usually 20% of the Medicare-approved amount.

The percentage of the expenses for Covered Services that the Member is required to pay once the Member's Deductible has been met, where applicable.

A percentage of costs shared by the health insurance Carrier and health insurance policy holder after the plan Deductible is met. Coinsurance generally ranges from the Carrier paying 100% down to the Carrier and health insurance policy holder splitting the costs 50/50%.

The amount that you pay for each medical service you get, like a doctor visit. Coinsurance is a percentage of the cost of the service; a copayment is usually a fixed dollar amount you pay for a service.

The portion of the bill that you are responsible for, once your deductible has been met. This is typically 20 to 30 percent and most policies have a cap on how much you must pay.

The percentage of allowable costs you pay for covered health care services after you satisfy your annual deductible; amounts vary by plan.

Percentage of covered expenses the insured party must pay for health care services above and beyond the deductible.

The percentage of a charge for services that you may have to pay after you pay any plan deductibles. In a Private Fee-for-Service plan, the coinsurance payment is a percentage of the cost of the service .

The amount of money you must pay. It is usually a percent of the total cost (for example, 10%, 15%, or 20% of the bill).

percentage of a bill for medical service that must be paid by the patient. See Copayment. Coinsurance may also refer to a cost sharing requirement under a health insurance policy which requires that the insured will assume a portion or percentage of the cost of health benefits.

CLOSE A percentage of costs that you must pay after you meet your deductible. Your in-network coinsurance is the percentage you pay to providers who are in your health plan. Your out-of-network coinsurance is the percentage you pay to providers who are not in your health plan.

a cost-sharing method by which a health insurance plan pays a percentage of the provider's covered expense (often after a deductible is met) and the participant pays the rest. For example, the plan may pay 80% and the participant may pay 20%. In this case, the 20% is the participant's coinsurance.

A clause that requires the insured to insure to value or share the loss with to insurance company.

In property insurance, a clause under which the insured shares in losses to the extent that he is underinsured at the time of loss.

A provision in a health insurance contract by which the insurer and insured share, in a specific ratio, the covered expenses under a policy. For example, the insurer may reimburse the insured for 80 per cent of covered expenses, the insured paying the remaining 20 per cent of such expenses.

An insured person's share of the cost of services; most frequently part of an indemnity plan. Coinsurance is usually expressed in a percentage form, such as 20%.

The portion of covered health care costs for which the covered person has a financial responsibility, usually a fixed percentage. Coinsurance usually applies after the insured meets his/her deductible.

The percentage of an allowable charge you must pay for a covered service.

a percentage of an eligible expense that you are required to pay for a covered service.

portion of covered health care costs for which the covered person has a financial responsibility, usually according to a fixed percentage. Often coinsurance applies after first meeting a deductible requirement.

The percent of the Medicare-approved amount that a Medicare beneficiary has to pay in addition to the deductible for Part A and/or Part B. In the Original Medicare Plan, the coinsurance payment is a percentage of the cost of the service (for example, 20%). In this example, coinsurance for a $100 x-ray would be $20.

An arrangement that requires you to pay a certain percentage of the cost of your health care after paying the deductible.

An arrangement under which the member shares a stated portion (usually a percentage) of the cost of care. For instance, under a plan in which there is an 80% coinsurance, the carrier would pay 80% of the allowed amount for the cost of the care. The member would pay the remainder of the cost until their out-of-pocket maximum has been met.

A type of cost-sharing in which the insured pays or shares part of the medical bill, usually according to a fixed percentage. Generally included in fee-for-service/indemnity plans.

The amount you may be required to pay for services after you pay any plan deductibles. In the Original Medicare Plan, this is a percentage (like 20%) of the Medicare approved amount. You have to pay this amount after you pay the deductible for Part A and/or Part B. In a Medicare Prescription Drug Plan, the coinsurance will vary depending on how much you have spent.

The amount you pay as your share of the medical services you receive, like for a doctor's visit. Coinsurance is a percentage of the cost of the service (e.g., 20%).

How you and your FEHB plan split the cost of covered medical expenses. For example, a 20% coinsurance means you pay 20% of most covered charges. The plan pays 80%.

The amount you pay as your share for the medical services you receive, such as a doctor’s visit. Coinsurance is a percentage of the cost of the service (you pay 20%, for example).

Term used by Centers for Medicare and Medicaid Services to mean the fixed amount or percentage of the Medicare-approved amount that a Medicare beneficiary must pay the provider for a covered service. Same as copayment. See also copayment.

Member pays a fixed percentage of the cost of each prescription dispensed. Coinsurance can be applied to all drugs or certain types of drugs. Examples: Coinsurance for brand drugs (i.e. 30% of cost for brand drug) or coinsurance for specialty drugs.

When submitting a claim, an amount of money that the insured must pay toward the cost of a claim. The insured usually pays the smallest percentage or dollar amount. It is used by insurers to keep health insurance costs low, and temper insureds from using benefits for minor claims.

A feature of some medical insurance plans in which the insurer and insured share any expenses above the deductible amount.

A relative division of risk between insurer and insured, depending upon the relative amount of the policy and the actual value of the property insured, and taking effect only when the actual loss is partial and less than the amount of the policy, the insurer being liable to the extent of the policy for a loss equal to or in excess of that amount.

An arrangement in a health insurance policy whereby you pay a portion of the expenses, and the insurance company pays the rest.

The amount that you have to pay for health care after you pay the deductible for Part A and/or Part B.

The percent of the covered medical expense that the employee is responsible for paying (Ex: employee pay 10%, plan pay 90%).

A payment arrangement where the patient pays a percentage of his or her health care costs and the health insurance pays a percentage. These are often referred to by the percentages, such as "80/20 plan" or "90/10 plan," indicating what percentage the plan pays and what percentage the member pays.

The amount of payment that is above the rate that Medicare (or other insurance) pays for medical services. Payment of this amount is considered the responsibility of the patient.

After a deductible is paid, this provision requires the patient to pay for a certain percentage of any remaining medical bills, usually 20 percent.

The percentage of covered expenses under a major medical plan that is paid once a deductible is satisfied. The most common coinsurance is 80 percent. A provision whereby a property owner must share in a loss if the amount of insurance carried is less than a specified percentage of value. A reinsurance arrangement in which a primary life insurance company cedes a specified percentage of the face amount of a policy or block or policies to a reinsurer.

The amount the insured is required to pay for medical care in a plan after the annual deductible has been met. Coinsurance rate is usually expressed as a percentage. For example, the insurance company may pay 80% of the covered claim, and the insured pays the remaining 20%. This would be called 80/20.

A policy provision, frequently found in medical insurance, by which both the insured person and the insurer share in a specified ratio (i.e. 80%, 20%), after the deductible is met.

the patient portion of a medical bill. It is usually a percentage of the total claim amount. For example, in an 80/20 plan, the insurance will cover 80 percent of the charge and the patient is responsible for 20 percent of the charge.

The amount the beneficiary pays toward the cost of a particular service. This can be expressed either as a percentage of the approved cost (20%) or as a set fee ($10 per visit). The coinsurance can vary based upon the type of insurance plan or even for different services within a plan itself. This term is often used interchangeably with the term "co-pay". However, a co-pay is generally limited to a set fee per service.

The portion or percentage of the Medicare-approved amount that a beneficiary is responsible for paying.

A cost-sharing requirement that provides that a Medicare beneficiary must assume a portion or percentage of the costs of covered services.  Medicare coinsurance amounts are usually stated either in dollars or as a percentage of the reasonable charge for services.

The portion of Medicare approved hospital and medical expenses, after subtracting any deductible, that Medicare does not pay. See: Medicare

The percentage of the medical expense for which you are responsible. For example, assume you have already satisfied your deductible. If you visit an in-network provider, you pay 20 percent of the Chickering contracted rate for most services. If you visit an out-of-network provider, you pay 40 percent of the allowed charges, plus any amount charged by the provider that exceeds the allowed amount.

A property insurance policy clause which states the amount of insurance the Insured is required to carry. This usually refers to a stated percentage of the value of the property at risk.

Refers to your share of the cost for covered medical expenses after you've met your deductible and after the health plan pays its portion.

The amount patients are required to pay through their insurance plan for reasonable medical expenses after a deductible has been paid (also referred to as a "copayment" in some plans). Often insurance plans require 20 percent to be paid by the patient, with 80 percent paid by the insurance company.

Ordinary coinsurance is defined as a transaction under which each of two or more insurers assumes a designated portion of the liability for the total risk and is liable for only such portion of any loss beginning at the first dollar of loss. (See Reinsurance.)

In reinsurance, a type of proportional reinsurance plan in which an insurer and a reinsured share the risk at a predetermined level. In medical insurance coverage, the percentage of all eligible medical expenses, in excess of the deductible, which is incurred as a result of sickness or injury and which an insured is required to pay.

The portion of the payment for medical services that an individual is responsible for. For example, your health coverage may pay for 80% of the costs of a service, while you will have to pay the remaining 20%.

A provision which limits the amount of the coverage paid by an insurance plan to a certain percentage, with the remaining costs paid by the member.

The amount you will have to pay for services once you have satisfied your deductible. This is often a set percentage (ex. 20%) of the total service cost, but in the case of prescription drug plans, it may vary depending on how much you've spent.

The portion of the cost of an item or service for which the beneficiary is responsible for paying; for Medicare Part B, that portion is 20%.

A provision of a program by which the insured shares in the cost of covered services on a percentage basis. The health plan assumes only a certain percentage of the cost while the covered person pays the remainder.

the amount of a claim not covered by the insurance policy which the policyholder is responsible to pay.

A provision in the property insurance policy which requires the insured to carry insurance equal to a certain specified percentage of the value of the property for the insured to receive full payment of a loss up to the amount of the policy. Otherwise, payment would be only a percentage of the actual loss (penalty), the percentage is determined by the amount of insurance carried to what should have been carried, as determined by the carrier.

Your share of the cost of your medical/dental coverage.

A method of cost-sharing in a health insurance policy that requires a group member to pay a stated percentage of all remaining eligible medical expenses after the deductible amount has been paid.

A cost-sharing requirement under a health insurance policy which provides that the insured will assume a portion or percentage of the costs of covered services according to a specified ratio. After the deductible is paid, this provision forces the subscriber to pay for a certain percentage of any remaining medical bills, usually 20 percent.

After a deductible is paid, a certain percentage of the costs incurred are paid by the policyowner and the rest by the insurance company (often 20% / 80%).

The division of the allowed amount to be paid by the insurance company and the patient, i.e., 80/20 or 90/10. (The first percentage is paid by the company - 80 or 90).

A sharing of the risk of an insurance policy by more than one insurer. Usually one insurer is liable up to a certain amount, the other liable above and beyond that amount.

The percentage of your medical costs you'll have to pay after satisfying any applicable deductibles.

The payment required from Medicare recipients for medical services. Medicare Part B coinsurance is 20% of Medicare allowable services. To find out current coinsurance amounts and days covered, please call 1-800-MEDICARE (1-800-633-4227).

The percentage you must pay for covered medical services after any deductibles have been satisfied. If you are participating in Option HD-1 and you have dependents enrolled, the family coinsurance maximum must be satisfied before any member of the family has benefits paid at 100%. The family coinsurance maximum may be satisfied by one member of the family or by two or more members of the family.

The amount you pay (usually a percentage) for your health care, after you pay the deductible.

In property insurance, requires the policyholder to carry insurance equal to a specified percentage of the value of property to receive full payment on a loss. For health insurance, it is a percentage of each claim above the deductible paid by the policyholder. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. After paying 80 percent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses.

The percentage of the costs of medical services paid by the subscriber.

This clause requires you to pay part of the loss if the coverage provided under the policy limits is less than a specified percentage of the property's value at the time of loss. For homeowner policies, the specified percentage is usually 80%.

A technique used to share the risk of a larger development between several insurance companies, each company covering a certain percentage of the total value of the insured property. Each policy may include a clause setting a minimum percentage of the total value of the insured property which the owner must keep insured in order to be eligible for payment under the policy.

The portion of covered expenses which a member must pay for care, after first meeting a deductible amount, if any.

The amount you are required to pay for medical care in a fee-for-service plan or preferred provider organization (PPO) after you have met your deductible. The coinsurance rate is usually expressed as a percentage of billed charges. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.

Medical Necessary

The percentage of covered costs you pay for services. Example: You pay 20% and the company pays 80% after deductible has been met.

Clause A clause requiring the insured maintains insurance on the property at least equal to a stipulated percentage of its value in order to collect partial losses in full.

The amount shared by you and your insurer for covered services after you have met your deductible. This is expressed in a ratio, typically 80/20 (80 percent paid by your insurer and 20 percent paid by you.)

An agreement between the insured and the insurance company where payment is shared for all claims covered by the policy. A typical arrangement is 80/ 20 up to $5,000. The insurance company pays 80 percent of the first $5,000 and the insured pays 20 percent. Usually after the $5,000, the insurance company then pays 100 percent of covered expenses during the remainder of the calendar year up to any limits of the policy.

The percent of the Medicare-approved amount that you have to pay for a medical service. For example, if your coinsurance is 20 percent and Medicare approves a $100 doctor office visit, Medicare will pay $80 and you will pay $20. With some plans, you do not pay coinsurance until you have first paid a deductible.

means the amount of covered regular and customary charges incurred by any Insured Persons, during the Policy Year for which benefits are payable at the rate set out in the Policy.

1) A provision under which an insured who carries less than the stipulated percentage of insurance to value, will receive a loss payment that is limited to the same ratio which the amount of insurance bears to the amount required; 2) a policy provision frequently found in medical insurance, by which the insured person and the insurer share the covered losses under a policy in a specified ratio, i.e., 80 per cent by the insurer and 20 per cent by the insured.

A sharing of hazard insurance insurance risk between the insurer and the insured. A coinsurance clause states the minimum percentage of value to be insured in order to collect the total amount of loss.

A sharing of insurance risk between the insurer and the insured. Coinsurance depends on the relationship between the amount of the policy and a specified percentage of the actual value of the property insured at the time of the loss.

Policy that states the minimum percentage of value to be insured in order to collect the full amount of loss. Policyholders must buy insurance in an amount equal to the value of the improvements to their property. Arrangement where the insured and insurer share on a proportional basis the payment for a loss.

A percentage of the eligible expenses that the Life Assured is required to pay first after the deductible, before the insurer pays.

A sharing of hazard insurance risk between the insurer and the insured, or others. A coinsurance clause states to what extent a loss will be covered based on the percentage of value insured.

Two meanings here: (1) In property insurance, a clause that states the insured will share in losses to the extent that he is underinsured at the time of loss, (2) In medical insurance, the insured person and the insurer share the covered procedures under a policy in a specified ratio (80 percent by the insurer and 20 percent by the insured).

The amount, calculated using a fixed percentage, you pay each time you receive covered services.

(1) In medical expense insurance coverage, the percentage, usually 10 to 25 percent, of all eligible medical expenses, in excess of the deductible, that the insured is required to pay. Also known as expense participation feature. (2) In reinsurance, a type of proportional reinsurance in which an insurer and a reinsurer share the obligations of a policy, including paying the death benefit and the nonforfeiture values, and establishing the reserves.

Two or more entities providing insurance protection and sharing in losses.

For Medicare, it is the percentage of the Medicare-approved amount that you have to pay after you pay the deductible for Part A and/or Part B. For other types of health insurance, it is usually a percentage of billed charges after you pay the deductible. For example, if you have paid the deductible and the insurance company then pays 70 percent of the remaining amount of your claim, your coinsurance is 30 percent.

Also known as "copayment", this refers to a provision in an insurance plan by which the beneficiary shares in the cost of certain covered expenses. Copayments are usually based on a given percentage of the total cost.

Coinsurance is an insurance-related term that often describes a splitting or spreading of risk between multiple parties.