reuben has policy 4 and has not visited the doctor all year. after a recent bicycle accident, he received a…

reuben has policy 4 and has not visited the doctor all year. after a recent bicycle accident, he received a bill from the hospital for $10,000. how much should he expect the insurance company to pay towards the bill? premium: $350 per month deductible: $500 per year copayment: $10 per doctor visit coinsurance: 10% after the deductible is met out - of - pocket maximum: $2,000 policy 3 premium: $250 per month deductible: $1,000 per year copayment: $15 per doctor visit coinsurance: 15% after the deductible is met out - of - pocket maximum: $3,000 policy 4 premium: $100 per month deductible: $7,500 per year copayment: $50 per doctor visit coinsurance: 25% after the deductible is met
Answer
Explanation:
Step1: Subtract deductible
The deductible for Policy 4 is $7,500. Subtract this from the hospital bill of $10,000. $10000 - 7500= 2500$
Step2: Calculate coinsurance amount
The coinsurance rate is 25%. So Reuben's share of the remaining amount is $2500\times0.25 = 625$.
Step3: Calculate insurance - company payment
The insurance - company pays the rest. First, find Reuben's total out - of - pocket cost. Since the out - of - pocket maximum is $5,000 and the deductible is $7,500 (which is already more than the out - of - pocket maximum), Reuben's out - of - pocket cost is $5,000. The insurance company pays $10000 - 2500= 7500$.
Answer:
$7,500$