"Domingo has a health insurance policy with the following provisions: $500 deductible, $50 copay, and 80/20 coinsurance provision. If Domingo has an accident that costs $3,000 in medical expenses, how much will he have to pay out of pocket?"

$1,150

Explanation:

Domingo first has to pay the deductible ($500), then the copay ($50) and finally he must pay for 20% of the medical expenses resulting from the accident (= $3,000 x 20% = $600). So Domingo's total expenses will be = $500 + $50 + $600 = $1,150

The deductible is a fixed amount that needs to be paid by the insured before the insurance company starts to pay its share of medical bills.

The copay is a fixed amount paid for each health care service provided.

The 80/20 provisions means that the insured is responsible for paying 20% of the medical expenses.

November 24, 2008

Explanation:

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