2 Replies to “Exactly how does medical insurance job?”

  1. just wondering why there is a co-insurance 20%? Is it if its is less than the 6000$ out of pocket that 20% co insurance applies? So basically the 20% co-insurance applies only if it doesnt reach the $6000 out of pocket? Sorry still trying to get the whole insurance thing!

    1. +Joe O Everything past $6,000 (or whatever your deductible is) is covered at 100%. Let me clarify.

      When you have a $50,000 bill, your co-insurance cost is technically $10,000. However, your limit is $6,000 so insurance has to eat crow and pay everything after $6,000. However, if your out of pocket were to be $13,000 then you would have to pay the whole $10,000 portion of the co-insurance.

      The 20% co-insurance applies in every scenario where you have co-insurance, but you end up paying less than 20% when your bill goes over your out of pocket limit.

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