Coinsurance
Coinsurance -sometimes called the reimbursement rate - is the percentage of eligible health or dental expenses your plan will pay after any deductible. It’s the insurer’s share of the bill, with the remainder paid by you. Typical plans cover 70–100% of eligible costs; the rest is your out-of-pocket portion.
Coinsurance matters because it directly determines your cost at the pharmacy, dentist, or therapist. A plan that pays 80% and leaves 20% to you can still save thousands yearly, but that remaining share adds up quickly for frequent claims. Most plans list coinsurance by benefit category - e.g., 80% for drugs, 90% for dental cleanings, 70% for vision care. It’s how insurers balance affordability and protection.
Example
If a physiotherapy visit costs $120 and your plan reimburses 80%, the insurer pays $96 and you pay $24.
What to Watch For
- Percentages can differ between benefits.
- Coinsurance applies after any per-visit or annual cap.
- Verify whether amounts are calculated before or after taxes-insurers differ.
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