Question
Don Phife owns a traditional indemnity health insurance policy with a $500 calendar-year deductible, 75 percent coinsurance provision for the insurance company, and a $5,000
Don Phife owns a traditional indemnity health insurance policy with a $500 calendar-year deductible, 75 percent coinsurance provision for the insurance company, and a $5,000 out-of-pocket cap (any deductible paid is included in the out-of-pocket tally). Find the amount that the INSURED would pay for each of the following expenses that occurred in the same calendar year. Show work for partial credit:
a. On January 15, Don broke a leg and incurred medical expenses of $800.
b. On April 23, Don consulted a cardiologist about chest pain he had experienced and was billed $400.
c. On June 11, Don was admitted to the hospital for diagnostic testing in relation to the chest pain that he had experienced. His expenses totaled $3,000.
d. On July 22, Don suffered a heart attack and was hospitalized for several days with bills of $4,000.
e. On November 3, Don underwent open-heart surgery, spent two weeks in the hospital, and incurred medical charges of $45,000.
f. On December 24, Don decided to have cosmetic surgery to change the look of his nose. The surgery is not considered medically necessary and costs $6,000.
ANSWERS January 15 __$_____ April 23 __$_____ June 11 __$_____ July 22 _$______ November 3 _$______ December 24 _$______
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