Question
Lucia, a sales representative, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through
Lucia, a sales representative, is 24 years old and has owned a major medical insurance policy for three years. The policy, which she purchased through her job, provides the following coverage:
a $2,000,000 lifetime limit | |
a $500 deductible and 80% coinsurance clause | |
internal limits of $500 per day for a semi-private room and board, $5,000 per occurrence for x-rays, prescription drugs, and other medical expenses, and a $25,000 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, Lucia was injured was grazed by a car while crossing the street. She spent 2 days in the hospital in a room that cost $750 per day, incurred $4,000 for other medical expenses, and $22,000 in surgical expenses.
Given these claim costs, complete the following table and answer the related questions
Policy Limit | Total Claim | |
---|---|---|
Hospital charges | $500 per day | |
Surgery costs | ||
Other medical costs | ||
Rehabilitation and therapy costs | ||
Deductible | ||
Co-insurance percentage |
% | |
Total cost of claim |
Based on this data, the total cost to the insurance company is $_________ , while the out-of-pocket cost to Lucia is $_______.
How much did Lucia 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 ($750 per day versus $500 per day). By how much would Lucias out-of-pocket cost for her hospital room change due in hospital billing ?
A. Lucias costs would decrease by $500.
B. Lucias costs would increase by $300.
C. Lucias costs would increase by $500.
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