Coinsurance

After you satisfy your $200 annual deductible, you must share many remaining expenses with the plan. This is called "coinsurance." Each individual covered under the plan has his or her own coinsurance. There are three coinsurance payment levels depending on the type of service or supply received and the type of health care provider used:

• 90%—10% Most benefits are paid at 90 percent by the plan and at 10 percent by you. When your coinsurance reaches $2,300 in a calendar year (the annual coinsurance maximum), benefits that would otherwise be paid at 90 percent are paid at 100 percent for the remainder of that calendar year. A family's annual coinsurance maximum is $4,600.
• 80%—20% Several services are paid at 80 percent by the plan and at 20 percent by you. These services always require 20 percent coinsurance and these coinsurance payments do not apply toward the $2,300 annual coinsurance maximum.
• 50%—50% Several services are paid at 50 percent by the plan and at 50 percent by you. These services always require 50 percent coinsurance and these coinsurance payments do not apply toward the $2,300 annual coinsurance maximum (except orthognathic surgery).