Question
Samantha takes her grandmother to the doctor. The receptionist asks Samantha for her grandmother’s proof of insurance. Samantha’s grandmother gives her two cards. The receptionist asks which insurer
should be billed first for the health care services. This scenario is an example of which type of cost sharing?
investment
coinsurance
copayment
deductible
should be billed first for the health care services. This scenario is an example of which type of cost sharing?
investment
coinsurance
copayment
deductible
Ask by Marsh Deleon. in the United States
Mar 20,2025
Upstudy AI Solution
Tutor-Verified Answer
Answer
This scenario is an example of coinsurance.
Solution
In this scenario, the situation described involves determining which insurer should be billed first for health care services. This is related to how health insurance plans coordinate benefits when a patient has multiple insurance policies.
The correct answer to this question is coinsurance.
Here’s a brief explanation of the terms for clarity:
- Investment: This typically refers to putting money into something for potential future returns, not applicable in this context.
- Coinsurance: This is a cost-sharing arrangement where the insured pays a certain percentage of the costs of covered services after the deductible has been met. In this case, it relates to how costs are shared between multiple insurers.
- Copayment: This is a fixed amount that the insured pays for a specific service at the time of receiving care, not directly related to which insurer is billed first.
- Deductible: This is the amount the insured must pay out-of-pocket before the insurance starts to pay. It does not pertain to the order of billing between insurers.
Thus, the scenario illustrates coinsurance as it involves the coordination of benefits between two insurance providers.
Answered by UpStudy AI and reviewed by a Professional Tutor
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Simplify this solution The Deep Dive
In this scenario, the type of cost sharing demonstrated is coinsurance. Coinsurance refers to the percentage of costs that insured individuals share with their insurance provider after meeting their deductible, typically after the insurance has started paying.
Samantha’s grandmother providing two insurance cards suggests she has dual coverage, which means both her insurers might participate in cost sharing for her health care services. This can often lead to reduced out-of-pocket expenses, as having multiple insurers may help cover costs that one plan alone cannot manage.
