Coinsurance

Coinsurance is the percentage share of a claim that the member pays after any deductible has been met, with the insurer paying the remaining percentage up to the annual aggregate limit. On most UAE policy wordings coinsurance and co-pay describe the same percentage share.

Updated

Coinsurance and co-pay in UAE wordings

In strict insurance usage, a co-pay is a fixed amount per visit and coinsurance is a percentage share. In UAE health insurance documents the two words are used almost interchangeably, and a percentage share is routinely printed as "co-pay 20%". Reading the definitions section of the policy wording is the only reliable way to know which mechanism a given document means.

Why it still matters

The distinction survives in one place that costs money: whether the share applies before or after a deductible, and whether it is capped. "20% coinsurance after a AED 500 deductible, capped at AED 5,000 a year" and "20% co-pay per visit capped at AED 50" describe wildly different exposure for the member, and both can appear on plans quoted at similar premiums.

What to check on the table of benefits

Whether the percentage applies to out-patient, in-patient or both. Whether pharmacy carries a different percentage. Whether there is a per-visit cap, an annual cap, or neither. Those three answers determine the member's real cost far more than the headline percentage does.

Where this comes up

Related terms

In Rabt

Every one of these is a field in Rabt

Co-pay, network, age band, waiting period — Rabt holds them as data on the plan, so a quote states them the same way every time and a comparison can line them up.