Which statement best differentiates a co-payment from a co-insurance?

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Multiple Choice

Which statement best differentiates a co-payment from a co-insurance?

Co-payments are fixed amounts paid for a service at the time of care, while co-insurance is a percentage of the bill you owe. This means a copay stays the same regardless of how expensive the visit is (for example, a $25 copay for a primary care visit), whereas coinsurance changes with the service cost (for example, 20% of a $200 bill would be $40). In many plans, coinsurance applies after any deductible has been met, adding a variable portion based on the actual charges. So the statement that best differentiates them describes a fixed amount per service for copays and a percentage of the bill for coinsurance. Choices that claim both are fixed amounts or that they’re the same thing don’t fit, and the role of a deductible is a separate concept from how copays and coinsurance are calculated.

Co-payments are fixed amounts paid for a service at the time of care, while co-insurance is a percentage of the bill you owe. This means a copay stays the same regardless of how expensive the visit is (for example, a $25 copay for a primary care visit), whereas coinsurance changes with the service cost (for example, 20% of a $200 bill would be $40). In many plans, coinsurance applies after any deductible has been met, adding a variable portion based on the actual charges. So the statement that best differentiates them describes a fixed amount per service for copays and a percentage of the bill for coinsurance. Choices that claim both are fixed amounts or that they’re the same thing don’t fit, and the role of a deductible is a separate concept from how copays and coinsurance are calculated.

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