Kate has a Major Medical Plan with 75/25 coinsurance and a deductible of $25. How much will she pay if she incurs a $125 bill before meeting the deductible?

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Study for the Louisiana Series 103 – Life, Health, and Accident or Sickness Insurance Exam. Familiarize yourself with key concepts through engaging questions and explanations. Prepare effectively for your exam!

Multiple Choice

Kate has a Major Medical Plan with 75/25 coinsurance and a deductible of $25. How much will she pay if she incurs a $125 bill before meeting the deductible?

Explanation:
The main idea is that deductible must be satisfied before coinsurance applies. In this plan, you pay the deductible first, then coinsurance kicks in on the remaining charges. For a $125 bill with a $25 deductible: - Kate pays the deductible amount: $25. - Remaining charges after deductible: $125 - $25 = $100. - Coinsurance on the remaining amount is 75/25, so Kate pays 25% of $100 = $25. Total Kate pays: $25 (deductible) + $25 (coinsurance) = $50. The insurer would pay $75 of the remaining $100.

The main idea is that deductible must be satisfied before coinsurance applies. In this plan, you pay the deductible first, then coinsurance kicks in on the remaining charges.

For a $125 bill with a $25 deductible:

  • Kate pays the deductible amount: $25.

  • Remaining charges after deductible: $125 - $25 = $100.

  • Coinsurance on the remaining amount is 75/25, so Kate pays 25% of $100 = $25.

Total Kate pays: $25 (deductible) + $25 (coinsurance) = $50. The insurer would pay $75 of the remaining $100.

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