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by red-indian 2509 days ago
You are responding to a post where he paid $7,900 for a $11,800 procedure.

Under ACA Bronze, the worst plan, his copay should have been 40%.

Is it your assertion that $7,900 is 40% of $11,800?

1 comments

? When you pay a % of the allowed amount that’s called coinsurance (not a copay). This is paid after deductible in most cases. So he would owe up to his deductible ($7,900) before his coinsurance would kick in.

A minimum value ACA plan must have > 60% AV and cover the essential health benefits. The coinsurance % is irrelevant so long as it meets those requirements.