Coinsurance is the percentage of the allowed amount you must pay the provider on claims for which the plan pays less than 100% of the allowed amount. This includes most medical services and prescription drugs purchased from a network retail pharmacy or any non-network pharmacy.

Copayment (or copay) is a set dollar amount you pay when receiving specific services, treatments, or supplies, such as for inpatient hospitalization, emergency room visits, or a prescription filled through our mail-order pharmacy.

To see the coinsurance amounts for various types of services, see the Summary of Benefits.