Does the coinsurance on health insurance apply to the total medical charge or the discounted charge after the health plan’s discount?
Dear Adding Up,
Your 20% share is 20% of the charges that the plan “allows”. This is the fee that the insurer has negotiated with the lab, in your case. Here is the trick — you have to pay your deductible first. So, you have a $250 deductible that you pay out of your own pocket first; then, when more bills come in, you pay 20% of those (again, 20% of the fee the insurer has negotiated).
The insurer is correct that you owe the $25, if you have not already spent $250. On the bright side, you are now $25 closer to meeting your $250 share.