- Coinsurance is a type of cost-sharing that requires a beneficiary to pay a percentage of the cost of a covered medical service or supply. Coinsurance is typically a fixed percentage of the Medicare-approved amount for the service or supply and is usually required in addition to any deductibles or copayments that may be due.
- For example, if a Medicare beneficiary visits a doctor for an office visit, they may be required to pay a coinsurance of 20 percent of the Medicare-approved amount for the visit. If the Medicare approved amount for the visit is $100, the beneficiary’s coinsurance would be $20, and they would be responsible for paying that amount in addition to any applicable deductibles or copayments.
- It is important to note that Medicare coinsurance amounts can vary depending on the type of service or supply a beneficiary is receiving, as well as the specific Medicare plan they are on. Some plans may have higher or lower coinsurance amounts for certain services or may have different coinsurance amounts for inpatient and outpatient services.
