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Q  What are the financial responsibilities of insured patients?
A Deductible
The amount you owe for healthcare services before your health insurance plan begins to pay. For example, if your deductible is $100, your health insurance won’t pay anything until you’ve met your $100 deductible for healthcare services. Your deductible many not apply to all services; for example, some plans offer a yearly mammogram or physical exam free of charge. (Source: Healthcare.gov. “Deductible.” Accessed May 27, 2015. https://www.healthcare.gov/glossary/deductible/.)

The fixed amount of out-of-pocket costs you pay when visiting the doctor’s office for a particular healthcare service. One example is a visit to your primary care doctor. If your co-pay is $20, that means you pay $20 per visit regardless of the reason for seeing your doctor, and your insurance company pays the rest.

The amount of covered benefits that the patient is responsible for paying after reaching his or her deductible amount. For example, if your coinsurance is 20 percent of medical costs, and your bill totals $100, you pay $20 and the insurance company is responsible for $80.

(Source: Davis, E. “Copay Vs. Coinsurance – What’s the Difference and Which is Riskier?” About Health, April 15. 

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