How Deductibles and Coinsurance Work

All of our plans involve either one or both of two important features: deductibles and coinsurance. Knowing how these work can help you better understand how health insurance works.

1. You pay the full amount of your health care costs until you reach your deductible.
2. Once you've reached your deductible, BCBSKS shares your health care costs with you. This is known as coinsurance. The percentage you pay can range from 20% - 50%, depending on the plan you pick.
3. Coinsurance has a maximum. Once that coinsurance maximum is met, BCBSKS pays 100% of your covered health care costs for the rest of the year (except for copayments, which you'll still have to pay).

	1. Deductible	2. Coinsurance	3. Full Coverage
You Pay	100%	50% or 20%	0%
BCBSKS Pays	0%	50% or 80%	100%
	You pay the full amount of your health care costs until you reach your deductible.	Once you've reached your deductible, BCBSKS shares your health care costs with you. This is known as coinsurance. The percentage you pay can range from 20% - 50%, depending on the plan you pick.	Coinsurance has a maximum. Once that coinsurance maximum is met, BCBSKS pays 100% of your covered health care costs for the rest of the year (except for copayments, which you'll still have to pay).

Figures are for illustrative purposes only. The examples provided in the chart relate to in-network service only. When using out-of network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSKS allowed amount and the provider's actual charge.