What is Co-Insurance?

Co-insurance is the percentage of the cost you pay for a dental procedure after you’ve met your annual deductible. It’s also referred to as cost-sharing.

Examples:

• Co-insurance does not include premiums, deductibles or the cost of non-covered services.
• If your policy has an 80/20 co-insurance split for basic dental treatments, and you have met your deductible, the insurance pays 80% of the treatment and you pay the remaining 20%.
• For a $200 filling, you would pay $40 if your co-insurance is 20%.

FAQs

• How is co-insurance different from out-of-pocket expenses? Out-of-pocket expenses refer to the total amount you pay for dental services, including deductibles, costs above your annual maximum and expenses for non-covered treatments. They can be higher than co-insurance.
• Does co-insurance apply to all dental services? Yes, but preventive and diagnostic services are typically covered at 100%. Co-insurance typically applies to basic and major services after the deductible has been met.
• Is co-insurance the same as copay? Co-insurance is a percentage of the cost while a copay is a fixed amount. Copays are common in medical insurance, but less so in dental insurance.

Example of Co-Insurance

This pie chart shows an example of the co-insurance you would pay for a covered dental procedure.

Let’s assume you have already met your deductible and your plan covers 80% of the cost. You are responsible for the remaining 20% as your co-insurance.

Delta Dental of Arkansas Offers Dental and Vision Insurance for Individuals and Groups

Are you interested in our dental coverage plans so you don’t have to pay the full dentist bill yourself? Check out our insurance options for individuals and families, and small, mid-size and large groups.

And while you’re browsing, take a look at our vision insurance, too.

More Dental Insurance Terms Explained

1. What is a premium?
2. What is a waiting period?
3. What is a network dentist?
4. What is a benefit period?
5. What are preventive/diagnostic, basic and major dental procedures?
6. What is a deductible?
7. What is a copay?
8. What is co-insurance?
9. What is an annual maximum?
10. What is a claim?
11. What is an explanation of benefits (EOB)?
12. What is a pre-determination of benefits?
13. What are out-of-pocket expenses?

Back to Dental Insurance Terms Explained: A Quick Guide

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