Trying to get me head around US Medical Bills and calculating how much is paid.
The scenario:
Health Insurance Plan
Deductibles = 5,000 (Fig 1)
Co Insurance is 30% (Fig 2)
Max Out of Pocket is 6,000 (3)
Medical Bill is 40,000 (4)
Deductible = 5,000 (1) (paid by policyholder)
Balance = 35,000 (5)
Apply Co Insurance percentage of 30% (2) to 35,000 (5) = 10,500 (6)
Gross Amount to be paid is 10,500 (6) + Deductibles 5,000 (1) = 15,500 (7)
Apply Max Out of Pocket of 6,000 (3)
Net Amount to Pay is 5,000 (1) (Deductibles) + 6,000 (3) (Max Out of Pocket) = 11,000 (8)
Is this calculation correct?
I know there are other things to be considered eg prescriptions, visit to doctor etc, and I will get to them once I understand this bit.
Grateful for some guidance on this.