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QUESTION CARD Q065 · HEALTH PLANS & COSTS

Cost Sharing

Understand the answer, compare the alternatives, and review the related terms.

CARD Q065

A covered in-network bill has an allowed amount of $2,800. The member has $800 of deductible remaining, then pays 20% coinsurance. With no copay or other limit involved, what does the member pay?

  1. $560
  2. $800
  3. $2,240
  4. $1,200
CORRECT ANSWER · D

$1,200

Pay the $800 deductible first. Coinsurance is 20% of the remaining $2,000, or $400. Total: $1,200.

Why each choice is right or wrong

A. $560

Incorrect. $560 applies 20% to the entire amount and omits the remaining deductible.

B. $800

Incorrect. $800 counts the deductible but omits $400 coinsurance.

C. $2,240

Incorrect. $2,240 is 80% of the entire allowed amount. It ignores the deductible and is not the member’s stated share.

D. $1,200

Correct. Pay the $800 deductible first. Coinsurance is 20% of the remaining $2,000, or $400. Total: $1,200.

Review the related terms

Use these lessons to revisit the concepts and try additional practice questions.

Sources & further reading