coinsurance (redirected from coinsurance clause)

coinsurance,

n 1. a means of sharing, dividing, or splitting the cost of dental services between the dental plan and the insured patient. A common division is 80/20. This means the insurance company will pay 80% of the cost of the dental service and that the patient will pay 20%. Percentages vary and may be applied to scheduled or usual, customary, and reasonable fee plans.
2. a provision of a dental benefits program by which the beneficiary shares in the cost of covered services, generally on a percentage basis.
3. the percentage of a covered dental expense that a beneficiary must pay (after the deductible is paid). A typical coinsurance arrangement is one in which the third party pays 80% of the allowed benefit of the covered dental service and the beneficiary pays the remainder of the charged fee. Percentages vary and may apply to a table of allowance plans; usual, customary, and reasonable plans; and direct reimbursement programs.

coinsurance clause,

n a provision in an insurance contract stipulating that the insurer will pay a specified share of dental expenses covered by the plan.