What is the difference between a copayment and coinsurance?

Updated on: October 26, 2018

Originally posted on: June 11, 2018

A copayment is the fixed amount that you pay for each prescription depending upon the formulary tier it is on. Usually the lower tiers on a plan’s formulary have copayments. The higher tiers on a plan often have coinsurance because of the high cost of those drugs. Coinsurance is a percentage of the cost of a medication and can vary for each medication you fill.