Coordination of benefits Deductible Participation (co-insurance) Internal limits Antonio's been hospitalized for an illness. His insurance company has started paying 90% of covered medical expenses. What does the 10\% of expenses Antonio will have to pay out of his pocket represent? Coordination of benefits Participation (co-insurance) Deductible Internal limits Caroline has standard, personal medical insurance. After a recent accident, she visited the emergency room. One of the questions on the admission form asked if the accident occurred at work. Deductible Participation (co-insurance) Coordination of benefits Internal limits Dmitri suffered a profound knee injury. Dmitri lives in a remote part of the country and depends on being in excellent physical condition to work. Dmitri has decided to be extra cautious when having his knee repaired. He is going to a major orthopedic hospital 2,000 miles away and having his surgery performed by one of the top 10 knee specialists in the country. He already knows that claims for the hospital services and the surgeon will exceed the reasonable and customary charges for his area. Dmitri is willing to pay extra for the peace of mind of knowing he received extraordinary care. Participation (co-insurance) Deductible Internal limits Coordination of benefits Frances, a restaurant owner, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through her trade association, 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 policy's stated internal limit, the hospital agrees to reduce the room rate to the policy's internal limit. Last month, Frances was injured during a severe grease file in her restaurant. She spent 3 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. Last month, Frances was injured during a severe grease file in her restaurant. She spent 3 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 Based on this data, the total cost to the insurance company is , while the out-of-pocket cost to Frances is How much did Frances 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 hospital's room rate and the insurance company's responsibility ( $350 per day versus $250 per day). By how much would Frances's out-of-pocket cost for her hospital room change due in hospital billing ? Frances's costs would decrease by $300. Frances's costs would increase by $300. Frances's costs would increase by $90. Coordination of benefits Deductible Participation (co-insurance) Internal limits Antonio's been hospitalized for an illness. His insurance company has started paying 90% of covered medical expenses. What does the 10\% of expenses Antonio will have to pay out of his pocket represent? Coordination of benefits Participation (co-insurance) Deductible Internal limits Caroline has standard, personal medical insurance. After a recent accident, she visited the emergency room. One of the questions on the admission form asked if the accident occurred at work. Deductible Participation (co-insurance) Coordination of benefits Internal limits Dmitri suffered a profound knee injury. Dmitri lives in a remote part of the country and depends on being in excellent physical condition to work. Dmitri has decided to be extra cautious when having his knee repaired. He is going to a major orthopedic hospital 2,000 miles away and having his surgery performed by one of the top 10 knee specialists in the country. He already knows that claims for the hospital services and the surgeon will exceed the reasonable and customary charges for his area. Dmitri is willing to pay extra for the peace of mind of knowing he received extraordinary care. Participation (co-insurance) Deductible Internal limits Coordination of benefits Frances, a restaurant owner, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through her trade association, 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 policy's stated internal limit, the hospital agrees to reduce the room rate to the policy's internal limit. Last month, Frances was injured during a severe grease file in her restaurant. She spent 3 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. Last month, Frances was injured during a severe grease file in her restaurant. She spent 3 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 Based on this data, the total cost to the insurance company is , while the out-of-pocket cost to Frances is How much did Frances 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 hospital's room rate and the insurance company's responsibility ( $350 per day versus $250 per day). By how much would Frances's out-of-pocket cost for her hospital room change due in hospital billing ? Frances's costs would decrease by $300. Frances's costs would increase by $300. Frances's costs would increase by $90