What is the difference between Medicare copayments (Co-Pay) and Coinsurance?

Both coinsurance and copayments (or "copays") are cost-sharing measures that require the patient to pay a portion of the cost of healthcare services. Original Medicare Parts A, B, and D, as well as Medicare Advantage, incorporate either coinsurance and/or copays to help keep costs down and help prevent Medicare abuse. There are some key differences between "coinsurance" and "copay":

• Definition: Coinsurance is a percentage of the total cost of a healthcare service that the patient is responsible for paying, while a copayment is a fixed amount that the patient pays for a specific healthcare service.
• Payment structure: Coinsurance is typically paid after the patient has met their deductible, whereas copayments may be required regardless of whether the deductible has been met.
• Amounts: Coinsurance amounts are calculated as a percentage of the total cost of a healthcare service, while copayment amounts are usually fixed dollar amounts.
• Coverage: Coinsurance is typically associated with insurance plans that have high deductibles and high out-of-pocket maximums, while copayments are more commonly associated with plans that have low deductibles and low out-of-pocket maximums.