In health insurance, what does 'coinsurance' mean?

Study for the New Mexico Health and Life Insurance Exam. Practice with flashcards and multiple choice questions, each question has hints and explanations. Prepare thoroughly for your certification!

Coinsurance refers to a cost-sharing arrangement between the insured and the insurer, where the insured is responsible for paying a specific percentage of the covered healthcare expenses after the deductible has been met. For example, if an insurance plan has a coinsurance provision of 20%, the insured pays 20% of the costs for a covered medical service, while the insurance company covers the remaining 80%. This structure incentivizes insured individuals to utilize healthcare services judiciously since they have a financial stake in the costs of their care.

This arrangement differs from other healthcare payment models. For instance, a fixed fee for doctor visits describes a copayment rather than coinsurance, which varies based on the cost of services. A full payment requirement before coverage starts refers to a deductible; coinsurance only comes into play once that deductible is satisfied. Discounts for healthy lifestyle choices pertain to wellness incentives and are unrelated to the concept of cost-sharing. Thus, the definition of coinsurance as a percentage payment aligns perfectly with option C.

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