Question

What is the difference between a co-payment and co-insurance?

a.

Co-payment refers to two spouses paying for the same coverage, and co-insurance refers to two spouses receiving the same benefits.
b.

A co-payment is a flat fee for each service, and co-insurance is based on a percentage of the costs incurred.
c.

Co-payment is when a group of individuals work to cover each other’s medical expenses, and co-insurance is when an individual has multiple insurance policies from different companies.
d.

A co-payment is when an employer helps an employee pay for insurance premiums, and co-insurance is when an employer helps an employee find better insurance than they could alone.

Answer 1

A co-payment is a flat fee for each service, and co-insurance is based on a percentage of the costs incurred.

c.

Answer 2

b. A co-payment is a flat fee for each service, and co-insurance is based on a percentage of the costs incurred.

Explanation:

A co-payment can be defined as a relatively small fixed amount of money that is required to be paid by a patient (insured) to a service provider such as a health insurer (health maintenance organization-HMO) as medical expenses before receiving any other service. Some examples of co-payment are the payment of $15 for a visiting gynecologist, £5 for prescribed drugs, ¥20 for x-ray etc.

On the other hand, co-insurance can be defined as the amount of money a patient (insured) is required to pay for a claim or covered charge after a deductible have been satisfied and it is typically expressed as a percentage of the costs incurred. It is usually split between the policyholder and the insurer on a 20% to 80% basis.

Hence, the difference between a co-payment and co-insurance is that, co-payment is a flat fee for each service, and co-insurance is based on a percentage of the costs incurred.