Does Tonik health have Coinsurance?

By: Mike Solis

We got an email the other day from a dad saying: “IA>?,??,>d like to sign my daughter up for the Tonik plan, but donA>?,??,>t understand the A>?,?_"coinsuranceA>?,?A_ part. Can you explain?”  I thought this would make a good Tonik blog entry. For those of you at home, Co-insurance is the percentage amount of money an insurance member will have to pay AFTER he/she satisfy the deductible.  Yes many insurance plans expect you to pay a portion of money after you have paid the deductible.


While Tonik benefits are slightly different in each state, currently none of the Tonik plans require coinsurance for medical related issues. This means that once the daughter meets her calendar year deductible, there are no additional charges (this is what is called co-insurance as explained above) for all medical-related covered services.


When it comes to the current Tonik dental benefits, however, there is co-insurance. So if his daughter has a check up, teeth cleaning, or initial x-rays there is no charge for Tonik members in network. If she has a cavity, however, she will have to pay the dental deductible (usually $25-$50 dollars depending on your state). Then she will pay 20% coinsurance for that cavity. This means that Blue Cross will pay 80% of the cavity and your family will pay the remaining co-insurance.


Hope this helps. If you would like to coinsurance in detail (what fun!), please contact our offices. If you are ready to apply you can access the application directly at www.healthapplication.com/tonik .