How does my deductible and coinsurance work?

Example: Let’s say you have incurred an eligible claim for $3,000 and your plan has a $1,000 deductible with 80/20 coinsurance:

  • $1,000 = deductible paid by you
  • $1,600 = paid by health insurance plan (80% of the remaining $2,000)
  • $400 = paid by you (20% of the remaining $2,000)

Your responsibility = $1,400

Health insurance plan responsibility = $1,600.

Copayments do not apply towards the deductible.