Question
Cho, an accountant, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through her
Cho, an accountant, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through her employer, provides the following coverage:
a $1,000,000 lifetime limit | |
a $2,500 deductible and 80% coinsurance clause | |
internal limits of $250 per day for a semi-private room and board, $4,500 per occurrence for x-rays, prescription drugs, and other medical expenses, and a $45,000 maximum limit per occurrence on surgical procedures | |
a $25,000 limit per occurrence on rehabilitation and physical therapy | |
if a hospital charges a room rate that is greater than the policys stated internal limit, the hospital agrees to reduce the room rate to the policys internal limit. |
Last month, Cho was injured when she was struck by a car while riding her bike to work. She spent 5 days in the hospital in a room that cost $350 per day, incurred $3,850 for other medical expenses, and $32,000 in surgical expenses.
Given these claim costs, complete the following table and answer the related questions
Policy Limit | Total Claim | |
---|---|---|
Hospital charges | $250 per day |
|
Surgery costs |
|
|
Other medical costs |
|
|
Rehabilitation and therapy costs |
|
|
Deductible |
| xxxxxxxxxx |
Co-insurance percentage | % | xxxxxxxxxx |
Total cost of claim | xxxxxxxxxxx |
|
Based on this data, the total cost to the insurance company is $_______, while the out-of-pocket cost to Cho is $______. How much did Cho save by having her medical insurance policy?
Assume that the hospital changed its payment policy to make the patient responsible for the difference between the hospitals room rate and the insurance companys responsibility ($350 per day versus $250 per day). By how much would Chos out-of-pocket cost for her hospital room change due in hospital billing ?
Chos costs would increase by $500.
Chos costs would decrease by $500.
Chos costs would increase by $350.
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