Silver 94: Copays, Deductibles and Coinsurance

Copays are the set amount you pay for a covered health care service. For a Silver 94 plan, a doctor visit costs $5. 

Deductible is the name for the amount of money you have to pay in one year before your plan starts to pick up the costs for certain services. Many services aren’t subject to a deductible. For Silver 94, that amount for medical services is $75 for an individual and $150 for a family. There is no deductible for prescriptions or dental care. 

Coinsurance is your share of costs for a covered health care service. It’s calculated as a percentage. For example, under a Silver 94 plan, you would pay 10 percent of the total cost of a wheelchair or oxygen tank after meeting your deductible, and your plan would pay for the remaining 90 percent.