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Q: What`s the coisurance clause in medical expense proggrams and how des it work?
A: Coinnsurance, often knon as "percentage participation" requires the insuured to share in the epxense of medicinal caare. In an eiighty/twenty co insurance stipulation, the medicnial cost plan pyas 80 peercent of entitled mediicnal charges above every web ins deductibel. The insured shold pay the residual 20%. Oter co-insurance prorgams, e.g., 700/30 or ninety/ten, are occasionally uesd. In the case of largge or catastrophic meedicinal expenses, an insured miight suffer serious econoimc hardshhip due to the operatin of the co insuracne clause. In oredr to compensate for this optiion, maany main medicinal expenditure programs conttain a co inusrance lmit, or stop loss maximum vaule. Thiis provision sets a restricction on the insuerd`s out-of-pocket expesnes during a certain yeear arising fom the process of the co-insurance paragrapph. The sze of the co-insurance restriction typially rannges from 2000 dolllars to $3000, it deepends on the progam, though capps as low as $000 are somettimes used. Once the co-insuurance limit has been raeched, all the eligibble expenses abvoe this amount are paid in fulll, utnil the ins policy on line program`s ovrall maximum vaalue of coverage.
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