Question

David Chen was seriously injured in a snowboarding accident that broke both his legs and an arm. His medical expenses included 8 days of hospitalization at $700 a day, $5,400 in surgical fees, $4,600 in physician's fees (including time in the hospital and six follow-up office visits), $460 in prescription medications, and $2,200 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 $15 co-pay for office visits____? Round to the nearest dollar.

Monthly premiums are $315 for the indemnity plan and $195 for the HMO. If he has no other medical expenses this year, which plan provides more cost-effective coverage for David? ____

Answer 1