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Chad Strong broke his leg in a skiing accident. He has a group health insurance plan at work that pays an 80%/20% after meeting the $2000 deductible. Chad has received the following bills that are related to his accident. Ambulance call $100 Laboratory work $270 Emergency room charge $1500 2-day hospital stay $2100 Surgeon’s fees $650 Pharmacy fees $135 Surgery suite and Follow up Dr. visits $150 operating room fees $1200 and recasting Radiologist’s fees $120 Physical therapy $650 How much will Chad have to pay for this accident if he already has $230 charged towards his deductible from previous medical expenses? How much will the insurance company pay?

1 Answer

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Final answer:

Chad will pay a remaining deductible of $1770 and 20% co-insurance of $1001, totaling $2771. The insurance company will pay for the 80% after the deductible which equals $4004 plus the $230 already contributed by Chad, resulting in a payment of $4234 by the insurance company.

Step-by-step explanation:

Chad Strong has a group health insurance plan that requires him to first meet a $2000 deductible, after which the insurance pays 80% of the costs, while Chad pays the remaining 20%. He has already paid $230 toward his deductible from previous expenses, so he only needs to pay $1770 more to meet the deductible. After that, the insurance will cover 80% of the remaining costs.


First, we add up all the medical expenses Chad has received:

  • Ambulance call: $100
  • Laboratory work: $270
  • Emergency room charge: $1500
  • 2-day hospital stay: $2100
  • Surgeon’s fees: $650
  • Pharmacy fees: $135
  • Surgery suite and Follow up Dr. visits: $150
  • Operating room fees: $1200
  • Radiologist’s fees: $120
  • Physical therapy: $650


The total comes to $6,775. Chad still has $1770 left towards his deductible. After subtracting this amount from the total, $5005 remains. The insurance will pay 80% of this figure, which amounts to $4004, and Chad will pay the remaining 20%, plus the deductible he hasn't met yet:



$5005 x 20% = $1001 (Chad's 20% co-insurance payment)

Add the remaining deductible: $1001 + $1770 = $2771


Therefore, Chad will pay a total of $2771, and the insurance company will pay $4004 plus the original $230 Chad has already contributed toward the deductible, making the insurance company's payment $4234.

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