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This is a great argument for having a SMALL set of STANDARDIZED insurance plans.

So there would be plans A, B, C, D, and E and every member of plan B, for example, would cover exactly the same stuff and have the same out-of-pocket costs. Only the premiums would be different, making it obvious which plan is better.

That's exactly what the insurers do not want. They want to keep it as confusing as possible. We must force them to simplify.

Does the Co-Pay one have a deductible? What's the Max out of pocket? That's probably the most important.

EBounding says

Does the Co-Pay one have a deductible? What's the Max out of pocket? That's probably the most important.

Co pay is not having any deductible while Coinsurance has deductible of about $1000 for individual and $2000 for family. I know about max out of pocket but not sure what that limit is. That I need to find out. But what are the other factors I should consider?

Would need to know the total cost of each and if you normally go to the doctor.

Last time I had that kind of choice, I figured that one would have to go to the doctor at least 4 times before the $20 copay version was cheaper.

Based on the information you've given and considering that they're the same premium, I'd go with the Co-pay. If an office visit is $200, you'd pay $20 with the co-pay instead of $40 with the co-insurance (20% you pay, 80% they pay).

But like you said, insurance gets complicated so I'm sure there's more that needs to be considered.

EBounding says

Based on the information you've given and considering that they're the same premium, I'd go with the Co-pay. If an office visit is $200, you'd pay $20 with the co-pay instead of $40 with the co-insurance (20% you pay, 80% they pay).

But like you said, insurance gets complicated so I'm sure there's more that needs to be considered.

Any idea of how much a normal doctor or specialist visit cost ?

Doctor might run $100-200, but a specialist will be like $1000. You'll go there, and they'll do "something" that will cost $500+ at least.

The important numbers are the max copay amount. If you get into an accident and have a broken leg, spending 2 days in the hospital with a 50K bill, you don't want to pay 20%.

That is the important number to consider. Likely both will have some kind of emergency, or operation deductible, and that's the one you need to worry about the most.

I know health insurance very well.

Your 80/20% plan likely has an office visit copay. If you do any other services, it will revert to 80/20, with a deductible. If you just visit the doctor for regular diagnostic stuff, it's likely a copay. 80/20 doesn't kick in until your deductible is satisfied. So you'd end up paying full price for MD visits all year round.

The copay plan you mentioned likely has a coinsurance portion too unless it's some sort of HMO.

You're missing lots of information. The only straight 80/20 plan I know of is Medicare.

For each plan, get the office visit copay, cost share of other services, deductible, out of pocket maximum, benefit maximums (if any). Prescription coverage, copay for brand, generic, and non-formulary.

Put the 2 side by side and compare. It'd help if you find out of it's a PPO, HMO, POS, etc, plan.

Just remember the brochures your employer is showing you is marketing material. Don't be afraid to ask them.

If it's an HMO - Ask what are the copays. HMO's usually don't have deductibles or coinsurances. But don't forget to ask. There are no out of network benefits for HMO.

If it's a PPO - Find out what the copays AND coinsurances are for both in-network and out-of-network. Get Deductible, out of pocket max, benefit caps (if any).

If it's a POS - there really are no networks. They will usually pay out but with higher co-insurances. Ask about copays (if any), deductibles, out of pockets, and maximums also.

Don't them confuse you by letting them call it something like for example an "indemnity plan." Almost all insurances will behave like the 3 I listed above.

Bighorse speaketh the truth.

A co-pay is your portion of the approved charges, not billed charges. Example: your doctor bills $120, the insurance approves $100, you pay $20 and they pay $80. There are generally maximum out of pocket amounts for private insurance plans, whereas Medicare doesn't have a cap on the out-of-pocket amounts.

Co-insurance is an insurance that covers co-pays, generally after a deductible. If you're discussing a Medicare plan, there are generalized co-insurances (called Medigaps) that cover the out-of-pocket amounts. These are regulated by the federal government.

The thing to consider when choosing a co-insurance is how much you can afford to pay out-of-pocket if there's a catastrophic illness that requires rehabilitation. Co-payments on that are very expensive.

Akki says

This is a great argument for having a SMALL set of STANDARDIZED insurance plans.

Absolutely!

This is a great argument for having a SMALL set of STANDARDIZED insurance plans...
Only the premiums would be different, making it obvious which plan is better.
I believe this is how the Dutch system is structured (this is going off a PBS documentary a couple year back. Featured an American fleeing SV, BTW.) You're forgetting one other element, which is customer service. Cheapest is not always best.

Good point. Customer service and time to pay, etc, could still be different.

But at least with a few standardized plans much of the complexity would be reduced.