Let’s look at a simple claim example of inpatient surgery to repair a leg fracture using both a stand alone high deductible, max out of pocket major medical plan with 80% coinsurance and then the composite plan paired with a $1,000 deductible MedPlus supplemental plan with matching coinsurance…

Inpatient Surgery totaling $14,250

Stand Alone Medical Plan:

You pay $5,000 to meet your deductible but that still leaves a balance owed of $9,250. You will share in that portion at 20% and your health plan will share at 80%. To satisfy the bill, you will pay a total of $6,850 and the plan will pay $7,400. Also note that you will have satisfied your Max Out of Pocket liability.

Composite Plan (Primary and MedPlus together):

You pay $1,000 to meet your MedPlus deductible but that still leaves a balance owed of $13,250. You will only have to meet your remaining coinsurance share to the additional $1,170 while the supplemental plan pays $4,680 and again the primary plan pays $7,400.

In this scenario, supplemental coverage would have saved you $4,680 and you have also satisfied your Max Out of Pocket liability.