Out of Pocket Calculator Help

Coinsurance

Coinsurance is a section in the Copay/Coinsurance sheet. Coinsurance involves a percentage of the covered allowable charges that you must pay out of pocket. You should only make an entry if the health plan model you are using in your scenario uses coinsurance, and you don’t want to use the default value provided in your model (meaning you want to customize your entry based on a specific health plan you are using in your scenario). Coinsurance can apply to participating hospitals, non-participating hospitals, or both. Typically PPO and Point of Service plans, when coinsurance is involved, the coinsurance level is different for participating hospitals compared to the level for non-participating hospitals.