Co-insurance is the amount of money that an insured person pays out of pocket after paying their deductible. It is usually a percentage of a claim such as 20% or 30%. For example, let's suppose someone has $10,000 of medical expenses and their deductible is $100 with 20% co-insurance. The insured would be responsible for the first $100, plus 20% of $9,900 ($1,980) or a total of $2,080. The remainder of the expenses would be covered by the insurance company up to the maximum limits of the policy. Many insurance policies also have stop-loss limits (e.g., $5,000) which specify the maximum amount that insured individuals need to pay out of pocket for co-insurance. Be sure to check policy co-insurance clauses carefully for specific details, which can vary according to the type of policy purchased and the sponsoring insurance company.
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