What’s the difference between a copay and coinsurance?

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Copay — A copay is a set fee that you pay for certain services such as prescription drugs. Copays also apply to doctor office visits and services performed during office visits under the Open Access option.

Coinsurance — For the Limited and Choice plans, this is the percentage of expenses for covered services that you pay after you meet your deductible and until you reach your annual out-of-pocket maximum. For example, for in-network care under the Plus Limited option, the coinsurance amount is 20 percent. For the Open Access option, it’s the percentage you pay for covered services other than doctor’s office visits.