Mark age 38 is insured under an individual medical expense policy that is part of a Preferred Provider Organization (PPO) network. The policy has a
Mark age 38 is insured under an individual medical expense policy that is part of a Preferred Provider Organization (PPO) network. The policy has a calendar-year deductible of $500, 90/10 percentage coinsurance, and an annual out-of-pocket limit of $3,000. Mark recently had minor surgery. The surgery was performed in an outpatient surgical center. Mark incurred the following medical expenses. (Assume that the charges shown are the charges approved by Marks insurer and that all providers are in the PPO network.) Outpatient X-rays and diagnostic tests $1,300 Covered charges in the surgical center $12,300 Surgeons fee $2,600 Outpatient prescription drugs $1,000 Physical therapy expenses $1,200 In addition, Mark could not work for two weeks and lost $2,000 in earnings. (15-1c) PART A. Based on the above information, how much of the expenses will be paid by the insurance company?
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