Question

# Jon Snow was recently stabbed with resulting medical bills of \$4,000. His health insurance includes the...

Jon Snow was recently stabbed with resulting
medical bills of \$4,000. His health insurance
includes the following:
\$1,000 calendar-year deductible
80/20 coinsurance clause
\$5,000 out-of-pocket max
1.
After insurance is applied, how much will Jon
owe for the medical bill?
2.
Jon needs surgery during the same calendar
year that costs \$30,000. After insurance is
applied, how much will Jon owe for the surge

Question 1.

medical bills = \$4,000

Deductible amount = \$1,000

Deductible amount is paid by Jon and 20% of the remaining amount is paid by Jon as per the coinsurance

Coinsurance dollar amount paid by Jon = 20% of \$3,000 = \$600

Jon Snow owes for the medical bill = \$1,000 + \$600 = \$1,600

Question 2.

Cost for surgery = \$30,000

Jon first pays \$1,000 deductible

out of the remaining amount \$29,000; 20% is supposed to be paid by Jon = 20% of \$29000 = \$5,800

total amount to be paid by Jon sums upto \$6,800 (\$1,000+\$5,800) but the out of pocket max = \$5,000

so Jon pays a total of \$5,000 and the insurer pays remaining \$25,000 (\$30,000 - \$5,000).

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