Copay VS Coinsurance

What difference does this mean for you? Well, it could easily be thousands of dollars! Let’s dive in a little deeper. Copays are a set amount of money you pay for a prescription. You could and most likely have a structure similar to $10 for generic drugs and $25 for brand name drugs. This is usually the best plan to have if it is offered to you with your company/plan. These plans are quickly being replaced by high deductible health plans which are cheaper to buy but harder to live with. With coinsurance commonly you pay a percentage such as 20% after your deductible is reached. With deductibles constantly getting larger this is becoming more of a problem.

Imagine we have a deductible of $3000 (which is fairly standard) and we are a healthy individual. All sounds great because I never use my insurance anyway. Well, that is, until we do need to use it. An average brand name prescription will cost you in the hundreds of dollars and we are paying 100% of the cost since we are in a high deductible plan. I guess we will put off that vacation a little longer huh? Explain that to the kids who have been wearing mouse ears for weeks!

mouse ears black

There are a few things you could do at this point though:

  • Get your doctor to change to a cheaper alternative (or have the pharmacist call for you)
  • Check the maufacturers website for coupons (see that post here)
  • Use a discount card and just pay for it (card available here)

If you do any of these things it can change the outcome of your situation for the positive. The only consideration for you is that by using a discount card it won’t help you meet your high deductible. If all goes well and you can use one the solutions maybe your vacation plans won’t be ruined.


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