Planning estimate only — not a quote, claim, or medical advice. Confirm with your plan documents.
Benefits worksheet
Copayments vs coinsurance: which costs more for this visit?
Enter a visit allowed amount, a flat copay, and a coinsurance % (with deductible left if needed). Side-by-side what you pay.
Your numbersStays on device
Your numbers
$
$
$
%
Copay structure costs less here
$40
gap between the two patient-share estimates.
- You pay with copay
- $40
- You pay with coinsurance path
- $80
Real plans may waive deductible on copays or combine both. Use your SBC rules when they differ.
Related estimates
Common questions
Copay is usually a flat dollar fee; coinsurance is a percentage after deductible.
Often for office visits, but not always. Adjust deductible remaining to match your SBC.
Deductible is one piece of cost sharing; OOP max caps the year. This page compares one visit's structures.
Yes. Some services are copay, others coinsurance. Run the structure that applies to the visit you are pricing.