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Question

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Explanation:

Identify the nature of the service and insurance coverage

The question asks for the amount of money a patient would owe for a noncovered service costing \$500, given that their indemnity policy has a coinsurance rate of 80-20 and they have already met their deductible.

By definition, a noncovered service is a medical service or treatment that is not included in the insurance plan's benefits. Therefore, the insurance company does not pay any portion of the cost, regardless of whether the deductible has been met or what the coinsurance rate is.

Calculate the patient's financial responsibility

Since the service is noncovered, the insurance responsibility is 0%, and the patient is responsible for 100% of the cost.

$$ \text{Patient Responsibility} = \text{Total Cost of Noncovered Service} = \$500 $$

Answer:

  • (A) \$0
  • (B) \$100
  • (C) \$400
  • (D) \$500 (Correct answer)