Out of pocket plan costs Oscar Wang was seriously injured in a snowboarding accident that broke both his legs and an arm His medical expenses included five days of hospitalization at $900 a day, $6,200 in surgical fees, $4,300 in physicians fees (including time in the hospital and eight follow up office visits), $520 in prescription medications, and $2,100 for physical therapy treatments All of these charges fall within customary and reasonable payment amounts If Oscar had an indemnity plan that pays 80 percent of his charges with a $500 deductible and a $5,000 stop loss provision, how much would he have to pay out of pocket What would Oscars out of pocket expenses be if he belonged to an HMO with a $20 co pay for office visits Monthly premiums are $155 for the indemnity plan and $250 for the HMO If he had no other medical expenses this year, which plan would have provided more cost effective coverage for Oscar What other factors should be considered when deciding between the two plans

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Posted on Sep 20, 2024

Out-of-pocket plan costs. Oscar Wang was seriously injured in a snowboarding accident that broke both his legs and an arm. His medical expenses included five

Out-of-pocket plan costs.

Oscar Wang was seriously injured in a snowboarding accident that broke both his legs and an arm. His medical expenses included five days of hospitalization at $900 a day, $6,200 in surgical fees, $4,300 in physicians fees (including time in the hospital and eight follow-up office visits), $520 in prescription medications, and $2,100 for physical therapy treatments. All of these charges fall within customary and reasonable payment amounts.

If Oscar had an indemnity plan that pays 80 percent of his charges with a $500 deductible and a $5,000 stop-loss provision, how much would he have to pay out of pocket?
What would Oscars out-of-pocket expenses be if he belonged to an HMO with a $20 co-pay for office visits?
Monthly premiums are $155 for the indemnity plan and $250 for the HMO. If he had no other medical expenses this year, which plan would have provided more cost-effective coverage for Oscar? What other factors should be considered when deciding between the two plans?