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Coverage and cost

  • What is coinsurance?

    Coinsurance describes a way of cost sharing between you and your health plan. If you have pharmacy coinsurance, you will pay for a certain percent of your prescription drugs. For example, your health plan may have an 80/20 coinsurance plan. This means that you pay for 20 percent of your pharmacy costs, and your health plan pays for the remaining 80 percent. If a drug cost $100, and you have a 20 percent coinsurance, then you would pay $20 for that prescription.

    With coinsurance, you save money by using drugs that are on your health plan's drug list, especially generic drugs. A drug list is a list of prescription drugs and supplies covered under your health insurance.

    The benefit of coinsurance is that you can have a direct impact on the cost of your personal health care. On a coinsurance plan, the less your prescription drugs cost, the less you pay.