Kim was injured in a freak accident in her dorm room and had to spend several days in the hospital.Her covered medical costs totaled $14,000.How much will Kim's health insurance policy pay for this claim given the following policy information?
$250 deductible per year
80/20 coinsurance
$1,500 per year out-of-pocket coinsurance cap

Question

Quizplus · Accepted Answer

Kim's insurance policy has a $250 deductible, which means she is responsible for the first $250 of her medical costs. After the deductible, the policy covers 80% of the remaining costs, and Kim is responsible for the remaining 20%. Kim's total medical costs were $14,000, so her insurance policy will pay 80% of the remaining costs after the deductible, which is $14,000 - $250 = $13,750. 80% of $13,750 is $11,000, so Kim's insurance policy will pay $11,000 for this claim.

Kim Was Injured in a Freak Accident in Her Dorm