Kevin has had an illness and an accident during the year. His combined out-of-pocket expense for both incidents was $1,000. The insurance company will now start to pay some of his medical expenses. What does the $1,000 represent? Internal limits Deductible Coordination of benefits Participation (co-insurance) Maria had a horrible accident that required a year of treatments and rehabilitation. Fortunately, Maria's policy has a stop-loss provision that limits how much out-of-pocket expense she has to pay Participation (co-insurance) Coordination of benefits O O O O Internal limits Deductible Rajiv has standard, personal medical insurance. After a recent accident, he visited the emergency room. One of the questions on the admission form asked if the accident occurred at work. Coordination of benefits Participation (co-Insurance) COCO Internal limits Deductible Simone, 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 $3,000,000 lifetime limit a $1,500 deductible and 80% coinsurance clause internal limits of $400 per day for a semi-private room and board, $7,500 per occurrence for x-rays, prescription drugs, and other medical expenses, and a $40,000 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, Simone was injured during a severe grease file in her restaurant. She spent 3 days in the hospital in a room that cost $600 per day, incurred $5,500 for other medical expenses, and $20,000 in surgical expenses. Given these claim costs, complete the following table and answer the related questions Policy Limit Total Claim Hospital charges Surgery costs $400 per day $ $ $ Other medical costs S 5 Rehabilitation and therapy costs $ $ Deductible $ Co-Insurance percentage % Total cost of claim 5 Based on this data, the total cost to the insurance company is $ while the out-of-pocket cost to Simone is How much did Simone save by having her medical insurance policy? 5 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 ($600 per day versus $400 per day). By how much would Simone's out-of-pocket cost for her hospital room change due in hospital billing? Simone's costs would increase by $600. Simone's costs would increase by $240. Simone's costs would increase by $360