Cost-sharing (also called out-of-pocket spending) is the amount you pay when you get health care services — like going to the doctor or hospital. Cost-sharing includes copays, coinsurance and deductibles. These terms are explained below. Cost-sharing does not include your monthly insurance premium.
Cost-sharing is different for each insurance plan and is often hard to understand.
If you buy your insurance through Vermont Health Connect (the “exchange”), you can see the cost-sharing amounts of each plan before you buy insurance. You can compare the premiums and cost-sharing for different plans. If you get insurance through a job, you can find cost-sharing information on a form called Summary of Benefits and Coverage.
Many health insurance plans have more than one kind of cost-sharing. For example, your plan might have a deductible and coinsurance. Or you might have copays for doctor visits and coinsurance for hospital visits.