Insurance: Cost sharing & OOPM

Front

What is the deductible amount in the given insurance example?

Back

$500

Front

Fill in the blank: In the given example, the insurer pays ___.

Back

15.6

Front

What is the out of pocket maximum in the given insurance example?

Back

$5,000

Front

What is meant by a "claim value of $20,000"?

Back

It is the cost of the medical issue (such as a broken bone)

Front

If this medical incident costs you $4,400 total (deductible + cost share), how much left would you have to pay before you meet your OOPM?

Back

$600

Answer explanation

Deductible: $500

• + 20% Cost share (copay): $3,900

• = $4,400

__________________________________________

$5,000: OOPM

• - $4,400: Your cost of medical incident

• = $600 amount left you would have to pay for ongoing medical issues (new incident, copays for follow-ups from this incident, etc.)

Front

What is the acronym of the medical insurance term that represents the total amount any & all medical issues would cost you for the year? (total amount of $ from your own pocket)

Back

OOPM