Question

calculate the amount of money a patient would owe for a noncovered service costing $900 if their indemnity policy has a coinsurance rate of 80-20, and they have already met their deductible.

multiple choice
$0
$180
$720
$900

Explanation:

Identify service coverage status

The question asks for the amount a patient owes for a Noncovered Services item costing \( \$900 \). By definition, health insurance plans do not pay any portion of noncovered services.

Apply indemnity policy rules

Under standard Indemnity Policy Rules, even if the patient has met their deductible and has an 80-20 coinsurance rate, these cost-sharing features only apply to covered medical benefits.

Calculate patient responsibility

Since the service is completely noncovered, the insurance company pays \( 0\% \) and the patient is responsible for \( 100\% \) of the cost:

$$ \text{Patient Owed} = \$900 $$

Answer:

• (A) $0
• (B) $180
• (C) $720
• (D) $900 (Correct answer)