After the deductible is satisfied, who typically pays the coinsurance in a major medical policy?

• A. The insured pays the coinsurance
• B. The insurer pays the coinsurance
• C. The hospital waives the deductible
• D. The government pays the balance

Answer: (A)

Coinsurance is the insured’s share of the cost after the deductible has been paid. In a major medical policy, you first meet the deductible, and then you begin paying a coinsurance percentage of the remaining eligible expenses while the insurer covers the rest, up to policy limits. For example, if the deductible is met and the coinsurance is 20%, you would pay 20% of the covered costs and the insurer would pay the remaining 80%, until you hit any out-of-pocket maximum. The typical arrangement is that the insured, not the insurer, pays the coinsurance. The other options don’t fit how most major medical plans work: the insurer doesn’t pay the coinsurance amount, the deductible isn’t usually waived by the hospital, and government payment isn’t part of a standard private policy.