To solve this problem, the easiest way is to take the initial amount and subtract $550 (or the deductible and the surgery copay). This leaves you with $3,809.00. This is a distinctly American issue, though, since insurance companies demand incredible discounts on the services a hospital or doctor’s office provides. In other parts of the world, the government takes on a bulk of the cost and the common person has to pay little to nothing.
That aside, this problem also depends on what time of year the surgery takes place. The insurance could end up paying more than $3,809.00 if Mr. Jones has met or almost met his deductible (which is usually the only out-of-pocket expense that one has to pay for most covered items).