In-network patient already met deductible. You performed an adjustment and therapeutic exercises. The allowed amounts are Adjustment $45 and Therapy $40. The insurance covers 80% of the services. How much does the patient pay out of pocket?

In-network patient already met deductible. You performed an adjustment and therapeutic exercises. The allowed amounts are Adjustment $45 and Therapy $40. The insurance covers 80% of the services. How much does the patient pay out of pocket?

• A. $25
• B. $85
• C. $17
• D. $68

Answer: (C)

When deductible is already met, you’re responsible for the coinsurance portion of covered services, while the insurer pays the rest. Add up the allowed amounts for both services: 45 + 40 = 85. Insurance covers 80%, so you pay 20% of 85, which is 0.20 × 85 = 17. Therefore, the out-of-pocket cost is $17.

When deductible is already met, you’re responsible for the coinsurance portion of covered services, while the insurer pays the rest. Add up the allowed amounts for both services: 45 + 40 = 85. Insurance covers 80%, so you pay 20% of 85, which is 0.20 × 85 = 17. Therefore, the out-of-pocket cost is $17.