Common use of Coinsurance Clause in Contracts

Coinsurance. The member’s share of the costs of a covered health care service, calcu- lated as a percent (for example, twenty per- cent (20%)) of the allowed amount for the service. The member pays coinsurance plus any deductibles owed. For example, if the health insurance or plan’s allowed amount for an office visit is one hundred dollars ($100) and the member has met his/her deductible, the member’s coinsurance payment of twenty percent (20%) would be twenty dollars ($20). The health insurance or plan pays the rest of the allowed amount.