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?
- $560
- $800
- $2,240
- $1,200
$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.