医保词汇：Copay,Deductible,Coinsurance的差别!目前在学习医疗保险业务,但是对于有些术语的概念还是不太清楚,急盼医保方面的大人指点迷津!Copay（Copayment）,Deductible,Coinsurance：我大概知道,这三个

Question

医保词汇：Copay,Deductible,Coinsurance的差别!
目前在学习医疗保险业务,但是对于有些术语的概念还是不太清楚,急盼医保方面的大人指点迷津!
Copay（Copayment）,Deductible,Coinsurance：我大概知道,这三个词都是指保险中需要承包人自己掏钱的一部分,但是不知道具体的区别在哪里.我会追加的30-50分,但是别不懂装懂误导我!

Answer 1

定义：
Co-payment: Co-payment or as it is called 'Co-pay' is the set amount that the insurance company requires you to pay for services such as doctor visits, prescriptions or emergency room visits.
Deductible: This is the set amount that you select and agree to pay out-of-pocket before the insurance company starts to pay any part of certain medical charges.
Coinsurance: This is the amount that the health insurance companies require you to pay as your portion of the medical charges. For example, with the 80/20 coinsurance requirement, after you have satisfied the deductible, if the hospital bill is $1000, then you are responsible for 20% ($200) and the insurance companies pays the balance 80% or $800.
三者的关系
Coinsurance is sometimes used synonymously with copayment, but is defined differently – a copay is typically fixed while the coinsurance is a percentage that the insured pays after the insurance policy's deductible is exceeded up to the policy's stop loss. It is expressed as a pair of percentages with the insurer's portion stated first. The maximum percentage the insured will be responsible for is generally no more than 50%. Once the insured's out-of-pocket expenses equal the stop loss the insurer will assume responsibility for 100% of any additional costs. 70-30, 80-20, and 90-10 insurer-insured coinsurance schemes are common, with stop loss limits of $1,000 to $3,000 after which the insurer covers all expenses.