Here’s an example of how it works with numbers plugged in. We’ll call it the “Ten Plan”, and keep the number simple.
Ten Plan (example)
• $10 Copay (after deductible met)
• 10% Coinsurance (after deductible met)
• $1,000 Deductible
• $10,000 Out-of-pocket maximum
So, in the Ten Plan, apart from paying your monthly premium, you’re going to pay out of pocket for the first $1,000 of your health care costs (i.e., your deductible). That includes doctor visits, lab work, x-rays, surgery, physical therapy, everything. After that, though, you’ll only pay $10 per doctor visit, and only pay 10% of other health care costs.
And, if you wind up spending $10,000 altogether in a given year, your health insurance plan picks up the cost of everything for the rest of the year. All you pay is your monthly premium.