Final answer:
Once a policyholder has met their deductible, the insurance company is responsible for the insured's claim expenses, minus any copayment or coinsurance, as per the policy terms. The policyholder may be responsible for a percentage of the expenses if coinsurance applies.
Step-by-step explanation:
When it comes to health insurance claims, after a policyholder has met their deductible, the eligible expenses essentially relate to the whole amount of the insurance claim.
That is to say that, considering the deductible has already been met, the insurer is responsible to cover the rest of the cost up to the policy limits, taking into consideration any applicable copayment or coinsurance amounts that the insured has to pay.
In the case where coinsurance is a part of the health plan, once the deductible has been paid, the policyholder would typically pay a percentage of the remaining medical expenses, while the insurance company would cover the rest. The percentage split varies according to the specific terms of the insurance policy.
Therefore, assuming that there are no additional copayments or policy limits affecting the claim, the insurance company pays the percentage of the costs as stipulated in the policy after the deductible is met.