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Do the Math #1: Health Care Coverage Amounts. Christina Haley of San Marcos, Texas, age 61, recently suffered a severe stroke. She was in intensive care for 12 days and was hospitalized for 18 more days. After being discharged from the hospital, she spent 45 days in a nursing home for medically necessary nursing and rehabilitative care. Christina had a comprehensive health insurance plan through her employer. The policy had a $1,000 deductible, a $50,000 episode limit, and a $250,000 annual limit with an 80/20 coinsurance clause with a $2,000 coinsurance cap. Christina’s policy covered the medically necessary services performed in a nursing home setting. Her total bill was $125,765.

  • a) How much of Christina’s expenses was paid by her insurance policy?
  • b) How much did Christina pay?

Do the Math #2: Health Care Coverage Amounts. Michael Howitt of Berkley, Michigan, recently had his gallbladder removed. His total bill for this event, which was his only health care expense for the year, came to $13,890. His health insurance plan has a $500 annual deductible and an 80/20 coinsurance provision. The cap on Michael’s coinsurance share is $2,000.

  • a) How much of the bill will Michael pay?
  • b) How much of the bill will be paid by Michael’s insurance?

 
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