The short answer
Copay, coinsurance, and deductible are the three main ways you share the cost of care with your health plan. A deductible is the amount you pay out of pocket before the plan starts paying. A copay is a fixed dollar amount you pay for a service, like a set fee for a doctor visit. Coinsurance is a percentage of a service's cost you pay after meeting your deductible. Together they determine what you owe for care, and understanding each helps you compare plans and predict your costs.
So a deductible is what you pay first, a copay is a fixed fee per service, and coinsurance is a percentage you pay after the deductible.
How they work together
In a typical plan, you first pay your deductible out of pocket. After that, you may pay a copay for some services and coinsurance for others, sharing costs with the plan until you reach your out-of-pocket maximum, after which the plan pays 100 percent of covered care. So the deductible comes first, copays and coinsurance apply during the cost-sharing phase, and the out-of-pocket maximum caps your total. Our guide to in-network vs. out-of-network costs covers how networks affect these amounts, and our glossary defines the terms.
The sequence is deductible first, then copays and coinsurance, capped by the out-of-pocket maximum.
Why it matters
Understanding these terms lets you compare plans accurately, since a low premium can hide a high deductible or coinsurance. A plan with low copays but a high deductible costs differently than one with the reverse, depending on how much care you use. Looking at all the cost-sharing pieces together, plus the out-of-pocket maximum, gives the true picture. Our glossary covers related terms. This is educational information.
The takeaway: a deductible is paid first, a copay is a fixed fee, and coinsurance is a percentage after the deductible — together with the out-of-pocket maximum, they define your real costs.
Frequently Asked Questions
What is the difference between a copay, coinsurance, and a deductible?
A deductible is what you pay before the plan starts paying, a copay is a fixed fee for a service, and coinsurance is a percentage of a service's cost you pay after meeting your deductible.
Do I pay a copay before or after my deductible?
It depends on the plan, but coinsurance generally applies after you meet your deductible, while some copays apply even before it. Both count toward your out-of-pocket maximum, which caps your total.
Why do these cost-sharing terms matter?
They determine what you actually owe for care, so understanding them lets you compare plans accurately — a low premium can hide a high deductible or coinsurance.
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