Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim?

Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim?

• A. $2,100
• B. $8,000
• C. $10,100
• D. $200

Answer: (A)

In a Major Medical plan, you first pay the deductible, then the coinsurance on the remaining eligible charges. Here, the bill is $10,100 and the deductible is $100, so you’re responsible for that $100 first. After the deductible, $10,000 remains to be shared at 80/20. The patient pays 20% of that amount, which is $2,000. Add the deductible: $100 + $2,000 = $2,100 total out-of-pocket. The insurance company would cover 80% of the remaining $10,000, which is $8,000.

In a Major Medical plan, you first pay the deductible, then the coinsurance on the remaining eligible charges. Here, the bill is $10,100 and the deductible is $100, so you’re responsible for that $100 first. After the deductible, $10,000 remains to be shared at 80/20. The patient pays 20% of that amount, which is $2,000. Add the deductible: $100 + $2,000 = $2,100 total out-of-pocket. The insurance company would cover 80% of the remaining $10,000, which is $8,000.