Christina Haley of San Marcos, Texas, age 61, recently suffered a severe stroke. She was in intensive care for 12 days and was hospitalized for 18 more days. After being discharged from the hospital, she spent 45 days in a nursing home for medically necessary nursing and rehabilitative care. Christina had a comprehensive health insurance plan through her employer. The policy had a $1000 deductible, a $50,000 episode limit, and a $250,000 annual limit with an 80/20 coinsurance clause with a $2000 coinsurance cap. Christina's policy covered the medically necessary services performed in a nursing home setting. Her total bill was $125,765.
(a) How much of Christina's expenses were paid by her insurance policy?
(b) How much did Christina pay?
Let's start with how much Christina will pay.
125,765 - 3,000 that Christina paid = 122,765.
The insurance company will be required to pay for the remainder. Even though there is a $50,000 episode limit, her insurance policy includes a ...
This solution calculates the amount that Christina will pay for her expenses, and the amount that will be paid by her insurance company. All calculations are shown and explained.