Co-Insurance in travel medical insurance

After paying the deductible, percentage or amount of covered expenses that the insured pays. When the insurance policy brochure says co-insurance is 20% or it is 80/20, it means that insurance company will pay 80% of usual and customary charges, and insured will be responsible for remaining 20%. Usually, in many plans, there is a maximum out of pocket amount after which insurance company pays 100% of covered expenses. E.g., Suppose you buy insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance, $1000 maximum out of pocket. Suppose you incur covered expense of $7250. You pay first $250 deductible. Out of $7000 covered expenses, insurance company will pay 80% for first $5,000 expense (i.e., $4,000). You pay 20% (i.e., $1000). For rest of $2000 expense, they will pay 100%. That means, you pay $250 + $1000 = $1250 total. And insurance company pays $4000 + $2000 = $6000. If you again later incur expense of, say, $3000, insurance company will pay all $3,000 as you have already satisfied your deductible and maximum out of pocket expense.

See Also: Covered Expenses; Coverage period in travel insurance; Co-pay; Co-payment; Customer service department; Coordination of benefits clause; Coordination of Benefits; Comprehensive major medical insurance; Common carrier AD&D beneficiary in travel insurance; Common carrier;

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