You have a health plan with a $5,000 deductible, a 20% co-insurance and a $10,000 out...

You have a health plan with a $5,000 deductible, a 20% co-insurance and a $10,000 out of pocket maximum.

You need surgery, which will require 3 days in the hospital. The hospital bill is $150,000 total.

How much will you pay?

Expert Solution

deductible is the amount you have to pay before the insurance money kicks in. Thus, you pay the first 5000$.

remaining bill = 150,000 - 5,000 = 145,000 $

20% co-insurance means you pay 20% of the remaining 145,000 = 0.2*145,000 = 29,000

your total costs so far are = 5000 (deductible) + 29000 (co-insurance) = 34,000 $

but, the out-of-pocket (which means the maximum limit upto which you have to pay) is 10,000 $.

Thus, you pay 10,000 $

Colby Messinger answered 2 years ago

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