Ace Your LLQP Exam 2025 – Unlock Your Licensing Potential!

Coinsurance in health insurance refers specifically to the percentage of costs that the insured is responsible for after their deductible has been met. This means that once the insured has paid their deductible, they will then share the costs of covered healthcare services with the insurer according to a certain percentage. For example, if a policy includes an 80/20 coinsurance clause, the insurance company pays 80% of the covered costs, and the insured is responsible for the remaining 20%.

This concept is important because it impacts out-of-pocket expenses for the insured, as it emphasizes the shared financial responsibility between the insurer and the insured. It does not refer to fixed amounts or the initial payment obligations, which belong to different terms within the health insurance framework, such as copayments or deductibles. Understanding coinsurance helps individuals better plan for their healthcare finances, as they need to be aware of how much they might owe for various services.