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Question
fill in the blank 8 points
alex has a health insurance plan with a deductible of $2,500, coinsurance of 80/20, and an out - of - pocket maximum of $3,000
alex receives a medical procedure that costs $10,000.
a. the total alex pays out of pocket for this procedure is $\boxed{type your answer...}$
after the medical procedure alex needed physical therapy. each session costs $75, he went to 5 sessions.
b. alex paid $\boxed{type your answer...}$ and his insurance paid $\boxed{type your answer...}$
Step1: Calculate post-deductible cost
$\$10,000 - \$2,500 = \$7,500$
Step2: Calculate coinsurance owed by Alex
$0.20 \times \$7,500 = \$1,500$
Step3: Calculate total out-of-pocket (Part A)
$\$2,500 + \$1,500 = \$4,000$. Compare to out-of-pocket max $\$3,000$; use the lower value.
Step4: Calculate total physical therapy cost
$5 \times \$75 = \$375$
Step5: Alex's payment for PT (Part B)
Since Alex already hit the $\$3,000$ out-of-pocket max, Alex pays $\$0$.
Step6: Insurance's PT payment (Part B)
$\$375 - \$0 = \$375$
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A. $\$3,000$
B. Alex paid $\$0$ and his insurance paid $\$375$