You have a health planwith a $5,000 deductible, a 20% co-insurance and a $10,000 out ofpocket maximum.
You need surgery,which will require 3 days in the hospital. The hospital bill is$150,000 total.
How much will youpay?
deductible is the amount you have to pay before the insurance money kicks in. Thus, you pay the first 5000$.
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 $
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