Nathan incurs a $5,500 hospital bill. His major medical plan has a $500 deductible. Expenses beyond the deductible are payable at 80%, not to exceed $2,000 out-of-pocket expense.
Nathan had $400 of charges that he paid before entering the hospital. How much will his insurance company pay towards his hospital bill?
$4,320
Martin has gall bladder surgery that requires a 4 day hospital stay. His policy has a $500 deductible and pays 80% with a maximum out-of-pocket of $5,000. The hospital bill is $8,500. What is Martin’s part of the bill?
$6,400
$6,800
$1,700
$2,100
Charles has a major medical policy that has a $1,000 deductible and a maximum out of pocket of $2,000. He has 80/20 coinsurance. He incurs a medical bill of $7,000. What will he have to pay?
$4,800
$2,200
Sarah wants to have her face lifted to look better. There is no medical necessity for this procedure. The insurance company will:
Pay the benefit if Sarah has been covered for two years
Pay a reduced benefit since it is not medically necessary
Exclude the benefit entirely
Harold has a policy that provides $5,000 basic hospital expense with a supplemental major medical that has a $500 deductible and 80/20 thereafter. He receives a surgeon’s bill for $3,000. How much will Howard pay out-of-pocket?
$0
$500
$1,000
Samantha has a basic plan with a
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