Let's say the following amounts apply to your plan and you need a lot of treatment for a serious condition. Allowable costs are $12,000. Deductible: $3,000 Coinsurance: 20% Out-of-pocket maximum: $6,850 You'd pay all of the first $3,000 (your deductible). You'll pay 20% of the remaining $9,000, or $1,800 (your coinsurance). So your total out-of-pocket costs would be $4,800 — your $3,000 deductible plus your $1,800 coinsurance. If your total out-of-pocket costs reach $6,850, you'd pay only that amount, including your deductible
and coinsurance (if your deductible applies to the Out-of-Pocket Max. The insurance company would
pay for all covered services for the rest of your plan year. Generally speaking, plans with low monthly premiums
have higher coinsurance, and plans with higher
monthly premiums have lower coinsurance.