David Chen was seriously injured in a snowboarding accident that broke both his
ID: 2783849 • Letter: D
Question
David Chen was seriously injured in a snowboarding accident that broke both his legs and an arm. His medical expenses included 7 days of hospitalization at $800 a day, $9,100 in surgical fees, $7,800 in physician's fees (including time in the hospital and eight follow-up office visits), $430 in prescription medications, and $1,500 for physical therapy treatments. All of these charges fall within customary and reasonable payment amounts.
If David has an indemnity plan that pays 90% of his charges with a $500 deductible and has a $5,000 stop-loss provision, how much will he have to pay out-of-pocket? Round to the nearest dollar.
What would David's out-of-pocket expenses be if he belonged to an HMO with a $30 co-pay for office visits? Round to the nearest dollar
Explanation / Answer
Total Charges= (7*$800)+$9100+$7800+$430+$1500 = $24,430
If David has an indemnity plan that pays 90% of his charges with a $500 deductible and has a $5,000 stop-loss provision, how much will he have to pay out-of-pocket? Round to the nearest dollar.
Payment= Deductible + Stop loss provision = $500+$5000 = $5500
What would David's out-of-pocket expenses be if he belonged to an HMO with a $30 co-pay for office visits? Round to the nearest dollar
Out of pocket expenses= office visit expense* No. of Visits = $30*8= $240
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