Co-insurance & Deductible Math for Medical Plans
Matt had a doctor bill of 1000. He had a deductible of $500 and 80/20 co insurance.
First step, remember what is what, that Matt has to pay the deductible first and then co-insurance kicks in. The first #, 80, is saying that the insurance company will pay 80% of the bill after the deductible is paid, The second #, 20, is saying that Matt will pay 20% of the bill after he has paid the deductible.
And they will ask you different things like:
-
- How much will Matt pay in total? (you would take the bill, 1000 minus his 500 deductible, you will get 500, then you need to get 20% of that, because that’s his share of the co-insurance. In the calculator you would type 500X 0.2= and it will be 100. So, Matt has paid a $500 deductible and a $100 co-insurance for a total of $600.)
-
- What will Matt pay for his share of Co-insurance? (here, you would do the same as before, subtract the deductible from the total, which gets you 500 and multiply that by 20% because that’s his share of Co- insurance, 500 x 0.2 = 100 and stop there because that’s all they are looking for.)
- What will the insurance company pay? (here, we begin the same, bill minus the deductible, 1000 – 500 = 500. Now we multiply that by 0.8 because 80% is the insurance companies share, so 500 x 0.8 = 400.)
Recommended: Gold
The GOLD Course is ALWAYS the recommended class series for all students as it teaches the material in more depth. Over 30 hours of the most in depth classes with a more intensive teaching of the topic. Learn more about L&H GOLD
Share the Post
Click to share the post to your network
