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There are many different types of health insurance plans in the marketplace.  It is our job to make the process as simple and efficient as possible.  Let's explore a little bit more about health insurance. 

Coinsurance is the percentage your health insurance carrier will pay after you have met your deductible. 

What Types of Plans Have Coinsurance?

There are way too many plans to choose from and it can become very intimidating.  Most all health insurance plans in California that are PPO have coinsurance.  Only some HMO plans in California have coinsurance.  Let us try to break down the basics of the types of plans in California that you might come across that have coinsurance.

  • HMOs (Health Maintenance Organization).  These types of plans are one of the most affordable in the marketplace.  This is primarily because of the managed network structure that is in place.  Individuals who have this type of coverage have to designate a primary care physician , which will be the starting point for all medical services that might be needed through out the year. 
  • PPOs (Preferred Provider Organization).  This is also another affordable individual health insurance plan that gives people access to all health care providers within the network.  Additionally, you can also go out of network and most plans will cover you for care as well.  This type of health insurance is flexible and affordable. 
  • HSAs (Health Savings Account).  The HSA is primarily used for tax-free strategies so individuals can save some extra money during tax time.  Also, HSAs have high-deductible plans which are primarily used as "just-in-case" insurance, or catastrophic coverage for those unfortunate emergency events.   

Should I Pick A Health Insurance Plan With A Low Coinsurance?

Generally yes.  Most PPO plans have a coinsurance which kicks in after you have met your plan deductible.  Some plans have coinsurance of 20 percent and others have coinsurance of 50 percent.  The percentage in the plan details page is what you are responsible for.  Most health insurance plans with coinsurance exclude doctors visits. 

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