How is "coinsurance" different from a copayment?

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Coinsurance is a payment structure in health insurance where the insured pays a certain percentage of the costs of a covered healthcare service after they have satisfied their deductible. Essentially, after the deductible is met, the insurer and the insured share the expenses based on the agreed percentage, which is where the term "coinsurance" comes into play. For instance, if a plan has a 20% coinsurance, the insured pays 20% of the covered costs, while the insurance company pays the remaining 80%.

On the other hand, a copayment (often referred to as a "copay") is a fixed amount that the insured pays for a specific service at the time of receiving care, regardless of whether the deductible has been met. For example, an insured might have a copayment of $25 for a doctor's visit and would pay that amount even if they have not fulfilled their deductible.

Thus, since coinsurance applies to expenses after a deductible has been met while a copayment does not factor in the deductible, the correct differentiation between these two concepts is clearly outlined in the response.

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