If your premium is $100, you will pay $100 every month for health insurance.
Say you have a $1,000 deductible and you're involved in an accident that requires hospitalization. Your health insurance will pay for the remaining covered expenses of your hospital bill after you reach your $1,000 deductible and any coinsurance amounts that you may owe.
If your coinsurance is 80/20 and you have a deductible of $1,000, your health insurance will cover 80% of your covered medical expenses once you meet your deductible. You will be responsible for the remaining 20%.
Say your out-of-pocket maximum is $5,000 and you are involved in an accident with medical fees reaching $100,000. Once you reach your deductible and after your coinsurance kicks in, your health insurance will cover the cost that extends beyond your out-of-pocket maximum up to the coverage period maximum.
Other common copay events include checkups with your primary care physician, which might be $50 per visit, and costs for generic medications, which could be $20. All copay fees apply toward your deductible.
*Examples are for illustration purposes only. Deductibles, coinsurances and out-of-pocket maximums vary by plan.