What percentage of costs must a major medical plan typically cover for the insured after the deductible has been met?

In major medical insurance plans, it is standard for these policies to cover 80% of the costs for the insured after the deductible has been met. This means that once the policyholder has paid their deductible amount for care, the insurance company generally takes responsibility for a significant portion of subsequent medical bills.

This 80% coverage is designed to share the financial responsibility between the insurer and the insured, allowing for affordability of healthcare services while also encouraging individuals to manage their healthcare costs. The insured remains responsible for the remaining 20% of the costs, often referred to as coinsurance. This structure helps ensure that individuals are involved in their healthcare decisions, as they will typically be more conscious of costs when they have a portion to pay out-of-pocket.

Understanding this percentage is crucial for clients when selecting a policy, as it impacts their overall out-of-pocket expenses and how much coverage they will have once they have reached their deductible. Thus, the correct answer highlights a common industry standard regarding cost-sharing between insurance providers and insured individuals.