Question

Roger has a traditional health insurance plan with $1000 deductible and 80/20 coinsurance, and $3000 out of pocket max. if roger had medical bills of $9,875, how much would he end up having to pay?

Answer 1

Total bill amount that Roger got was $9875.

The deductible is $1000. Therefore, Steve will have to pay the $1000 and the remaining amount of $8875 he will pay @20% subject to a maximum (cap) of $3000.

Therefore, the amount Roger will have to pay (subject to a maximum (cap) of $3000) is:

$1000+\frac{20}{100}\times 8875=2775$ dollars. (This is less than the cap of $3000).

Therefore, Roger would end up paying $2775.

Answer 2

Medical bill = $9,875
Deductible = $1,000

Amount Roger will pay =1000 + (9875-1000)*20/100 = 1000+1775 = $2,775