Expenses paid by insurance policy


Problem:

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?

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Finance Basics: Expenses paid by insurance policy
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