Florida 2-15 Life, Health and Variable Annuity AgentFlorida Laws and Regulations Specific to Health InsuranceMedium
A Florida resident has an individual medical expense policy with a $500 deductible and 80/20 coinsurance. After meeting the deductible, the insured incurs $3,000 in covered medical expenses. What is the insured's coinsurance payment for these expenses?
- A$200
- B$500
- C$700
- D$600
Show answer & explanationAnswer & explanation
Correct answer: D. $600
The deductible is paid first. The coinsurance applies to the remaining expenses. $3,000 (total expenses) - $500 (deductible) = $2,500. The insured's coinsurance is 20% of $2,500, which is $500.
Why the other options are wrong
- A. This would be 20% of $1,000, not the remaining expenses.
- B. This is the deductible amount, not the coinsurance payment.
- C. This calculation is incorrect.
Coinsurance Calculation
The calculation of the insured's share of covered medical expenses after the deductible has been met, based on a specified percentage.
- Deductible is paid first by the insured.
- Coinsurance applies to expenses remaining after the deductible.
- The insured pays their percentage, the insurer pays the rest.
Memory trick: Deduct First, then COIN-Share the Rest