Question

ou were in an accident that required surgery and five days of recovery in the hospital. Your total hospital bill reached $100,000. At the time of your accident you had previously paid nothing in health care costs for the year. Your health insurance has a deductible of $500 per year, a coinsurance rate for hospitalization of 10%, and an individual out-of-pocket maximum payment of $5000 for the year. How much must you pay out-of-pocket for your care in this situation

Answer 1

Answer: $5,000

Step-by-step explanation:

The hospital bill reached $100,000. It will then be first subject to the deductible of $500 per year.

Adjusting for that will give us,

= 100,000 - 500

= $99,500

This is the net amount payable

Then we calculate the Coinsurance cost of 10% to the person for the stay in the hospital.

We will have,

= 99,500 * (0.1)

= $9,950

$9,950 is what the person is supposed to pay but because the individual out-of-pocket MAXIMUM payment is $5,000, they pay that Maximum.

Therefore $5,000 is how much the person pays out-of-pocket for their care in this situation.

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