Question About Coinsurance

[scottfanli]

Quick question about coinsurance guys. I know a lot of policies have 80 percent, 70percent coinsurance etc... but how much would major services such as hospitilization, surgery, lab work etc... be with a policy that pays 80 percent coinsurance where the customer pays the 20?

thanks

 

[somarco]

If admitted thru the ER, figure $10k and up during the first 24 hours. Some bills will approach $30k the first day.

You do the math.

 

[Norwayguy]

Quick question about coinsurance guys. I know a lot of policies have 80 percent, 70percent coinsurance etc... but how much would major services such as hospitilization, surgery, lab work etc... be with a policy that pays 80 percent coinsurance where the customer pays the 20?

thanks

Whats the stop loss?...if 80/20 to 10,000 then the client pays deductible and $2000 if 80/20 to 15,000 then client pays deductible and $3,000 I think you get the idea

 

[LGilmore]

You first should make sure a policy you're reviewing HAS a stop loss threshold. Some don't. So you could pay the co-insurance forever.. (especially out of networks).

But there should be a point where 100% coverage occurs.

Example... Son busted his ankle in a Lacrosse match... $40,000 total bill.. our cost $3,500. Of which $500 was deductible and $3,000 was co insurance, which maxed out for the bill. There after for the balance of the year, all his medical costs (except copays, rx) were covered at 100%.

I told him now was the time for that sex change operation he always wanted as it would be covered....

 

[SportsNut]

I told him now was the time for that sex change operation he always wanted as it would be covered....

And here is what your son heard...

"Now is the time for that SEX............" Glazed over thinking about the event... (if he is like most kids)

 

[LGilmore]

"Now is the time for that SEX............" Glazed over thinking about the event... (if he is like most kids)"

And that's when he said "wow this IS really good insurance."

 

[hlink20]

If admitted thru the ER, figure $10k and up during the first 24 hours. Some bills will approach $30k the first day.

You do the math.

I agree with what you are saying. Depending on the cost of what each event will be, determines your actual cost out of pocket minus your deductible.

 

[somarco]

Depending on the cost of what each event will be, determines your actual cost out of pocket minus your deductible.

The plan benefits have no bearing on how quickly you run up claims.

 

[bill3173]

You first should make sure a policy you're reviewing HAS a stop loss threshold. Some don't. So you could pay the co-insurance forever.. (especially out of networks).

Blue Cross unleashed some of those plans this year without a stop loss in many states.

I wouldn't write one those plans for anyone, in fact, I don't present them as an option. They'll have to buy them from some other asshole.

I had a $132K claim for one client in '08, with a stop loss of $2k. Just think, if there'd been no stop loss on 80/20. There would have been a convenient memory loss to match.

 

[Guest]

I always like the way you think my Brother!! I concur. Save a buck today, lose your house tomorrow, brilliant!

Blue Cross unleased some of those plans this year without a stop loss in many states.

I wouldn't write one those plans for anyone, in fact, I don't present them as an option. They'll have to buy them from some other asshole.

I had a $132K claim for one client in '08, with a stop loss of $2k. Just think, if there'd been no stop loss on 80/20. There would have been a convenient memory loss to match.