Answer:
- insurance: $380
- Laura: $820
Explanation:
You want to know who pays what when Laura is billed $1200, her coinsurance is 10%, and she has met $800 of a $1500 deductible.
Coinsurance
The coinsurance Laura must pay is 10% of the amount of the bill in addition to any remaining deductible. Laura's coinsurance is ...
10% × $1200 = $120
Deductible
The amount of the bill exceeds Laura's remaining deductible, so she must also pay the full amount of that. The remaining deductible Laura must pay is $1500 -800 = $700.
Laura's cost
The total amount Laura must pay on this bill is ...
$120 +700 = $820 . . . . Laura pays
Insurance
The insurance policy will pay the remaining amount of the bill:
$1200 -820 = $380
= 90% × $1200 -700 = $1080 -700 = $380 . . . . insurance pays
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Additional comment
The coinsurance amount, and the sum of all payments, is based on the price of the procedure negotiated between the provider and the insurance company. This may differ substantially from the amount billed for the procedure.
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