What will an insured with a comprehensive major medical insurance policy pay after a $1,000 deductible and an $11,000 bill?

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In a comprehensive major medical insurance policy, after the insured has met their deductible, the insurance typically covers a significant portion of the remaining medical expenses, while the insured is responsible for a co-insurance amount and possibly additional out-of-pocket limits.

In this scenario, the insured must first pay the $1,000 deductible. After the deductible is paid, the remaining bill is $10,000 ($11,000 total bill minus $1,000 deductible). Assuming the policy covers a percentage of the remaining costs, let’s say the insured is responsible for a co-insurance rate of 20%.

To illustrate how this works:

  1. Calculate 20% of the $10,000 remaining after the deductible, which is $2,000.

  2. Next, add the $1,000 deductible to the $2,000 co-insurance, leading to a total of $3,000 in out-of-pocket costs for the insured.

Thus, the amount that the insured will need to pay after meeting their deductible and accounting for their co-insurance responsibilities results in a total of $3,000.

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