An insured covered by a group major medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. assuming the plan had a $1,000 deductible and an 80/20 coinsurance clause, how much will the insured be responsible to pay with $11,000 in covered medical expenses?

Question

Case Hampton

Business

22 November, 00:04

An insured covered by a group major medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. assuming the plan had a $1,000 deductible and an 80/20 coinsurance clause, how much will the insured be responsible to pay with $11,000 in covered medical expenses?

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Answers (1)

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Kamari Humphrey · Answer 1

This will be done as follows;

Total bill is $11,000

Subtracting the Deductible $1,000, we get a remainder of $10,000

Coinsurance is 80% or 0.8

Therefore; the amount insurer pays will be 0.8 * $10,000 = $8,000

On the other hand; the insured's coinsurance will be;

0.2 or 20% of $10,000 we get $2,000

Thus, the insured's total cost would be; the insured's coinsurance + the insured's deductible;

We get; $2000 + $1000 = $3,000

Therefore; the correct answer is $3,000