Question

A surgery that Jamal needs costs $34,000. if he has the surgery done at a medical facility his insurance company has preapproved (in-network), insurance will pay 80% of the cost. if the procedure is done out of network, insurance will pay half the cost. what is the difference on jamal's final bill to stay in his insurance provider's network?

a. $17,000
b. $27,200
c. $6,800
d. $10,200

Answer 1

The difference in Jamal's bill for an in-network versus out-of-network surgery is $10,200. For in-network, he pays $6,800, while out-of-network, he would pay $17,000 (option a).

Step-by-step explanation:

The question asks us to calculate the difference Jamal would pay for a surgery depending on if he used an in-network or out-of-network medical facility, based on his insurance coverage terms.

If Jamal has the surgery at an in-network provider, his insurance would cover 80% of the cost, leaving him to pay the remaining 20%. In this case, Jamal would pay:

• 20% of $34,000 = 0.20 × $34,000 = $6,800

If he goes out-of-network, the insurance covers 50% of the cost, and Jamal would have to pay the other 50%. In this scenario, Jamal would pay:

• 50% of $34,000 = 0.50 × $34,000 = $17,000

The difference in Jamal's final bill by staying in-network versus going out-of-network is:

• $17,000 (out-of-network) - $6,800 (in-network) = $10,200

Therefore, the difference on Jamal's final bill to stay in his insurance provider's network is $10,200 (Answer D).