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Theresa Morgan of Boone, ia, age 55, recently suffered a stroke. Her total bill for this care was $125,500. After leaving the hospital, she spent 25 days in a nursing home that cost $170 per day. Theresa, who earns $4,500 per month, missed two months of work. Theresa had a health insurance plan through her employer. The policy had a $1,000 deductible and an 80/20 coinsurance clause with a $2,000 coinsurance cap. She had also accumulated 21 sick days (equivalent to one month) at work. Otherwise, she had no long-term care or disability insurance. She was out of work for a total of 42 days. What is the total cost Theresa has to bear after considering insurance and sick days?

a) $17,140
b) $21,000
c) $26,200
d) $31,500

1 Answer

4 votes

Final answer:

After calculating Theresa's hospital and nursing home expenses, deductible, coinsurance, and lost wages minus sick days, the total cost she has to bear is $7,500. This does not match the answer choices, suggesting an error in the question.

Step-by-step explanation:

The total cost Theresa has to bear after considering insurance and sick days is calculated as follows: Hospital bill: $125,500 Nursing home stay (25 days at $170 per day): 25 * $170 = $4,250 Total medical expenses: $125,500 + $4,250 = $129,750 Deductible paid by Theresa: $1,000 Expenses after deductible: $129,750 - $1,000 = $128,750 Theresa's 20% coinsurance: 20% of $128,750 = $25,750, but capped at $2,000 Total medical costs covered by insurance: $129,750 - $2,000 (coinsurance cap) = $127,750 Theresa's total medical costs: $1,000 (deductible) + $2,000 (coinsurance) = $3,000 Wages lost (42 days out of work - 21 sick days to cover one month): $4,500 for the uncovered month Total cost to Theresa: $3,000 (medical costs) + $4,500 (lost wages) = $7,50 Therefore, the correct answer is (a) $7,500, which does not match any of the answer options provided. The question appears to contain an error in the answer choices.

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