1.

a. According to the health policy shown on this card, if the insured patient required a medical procedure from an in network doctor, the patient would have to pay _____ of the cost of the procedure, after first paying a deductible of _______. (20%, $1,000 / 10%, $150 / 10%, $1,000 / 90%, $1,000)

b. You need to have several cavities filled at the dentist. Your insurance policy covers 85% of the cost, with a maximum allowable of $400 for the procedure. Your dentist charges you $450. How much money will you owe for this procedure? ($110 , $340 , $450 , or $67.50)

Sample Insurance Card Policy Number A1234_123 Group Number 1234567 Group Name ABC Midwest Enrollee Name Ole Olson Enrollee ID 1162017 PCP: XYZ Family Practice Office Copay $15 Specialist$15 Emergency Room $150 Urgent Care $35 RX Generic Copay $25 RX Brand Copay $50/575 RX BIN# 56789 Network Coinsurance In Network 90%/10% Out of Network 80%/20% Deductible: $1000 Member Services: 1-800-XXX-XXXX Nurse Information Line: Call: 1-800-XXX-YYYY Hours of Operational 24 hours/7 days a week You have to choose a primary care doctor. Referrals are required for most other services. For mental health or substance abuse pre-approval or coverage questions call 1-800-XXX-ZZZZ. In an emergency call 911 or go to the nearest emergency room This card is for identification only and is not a guarantee of coverage. See your plan documents for information about your plan requirements