Understanding Health Insurance Copays, Deductibles, and Coinsurance

Posted September 10, 2026

Health insurance is associated with many different terms, and many of them may be unfamiliar. Understanding the basics, however, can make it easier to select the right plan and then manage your healthcare costs. Three of the most important health insurance terms you need to know include deductibles, copays, and coinsurance.

Deductible

This is the amount you pay out of pocket for covered health insurance services before your insurance starts to share the cost. For instance, if your plan has a $2,000 deductible, you will generally pay for eligible medical expenses until you reach this amount. Some preventative services may be covered before you meet your deductible, depending on which plan you have.

Copay

This is a fixed amount you pay for certain healthcare services, such as a doctor’s office visit or prescription medication. For example, you might have a $30 copay for a primary care appointment, while your insurance covers the remaining cost.

Coinsurance

This is the percentage of costs you pay after you meet your deductible. If your plan has 20% coinsurance, you will pay 20% of the covered medical bill while your insurance pays the remaining 80%. This cost-sharing continues until you reach your plan’s annual out-of-pocket maximum.

Knowing how these three costs work together can help you better estimate your healthcare expenses and compare insurance plans with confidence. If you are unsure which plan best fits your needs, contact us at Legacy Insurance Partners.