Theo is estimating his total out-of-pocket medical costs for an upcoming surgery. Use the following chart to answer the question: Service Type Visits or Specialties Cost to Patient Annual Deductible for Hospital Charges $1,800 Hospital Coinsurance 15% of total Home Health Visit Coinsurance First 20 visits 5% Over 20 visits 30% of each visit Physician Visit Co-payment $15 Specialist Visit Co-payment $40 Physical Therapy Co-payment First 10 visits $20 each Physical Therapy Coinsurance Over 10 visits 20% of each visit Emergency Room Co-payment $50 Ambulance Co-payment $500 Calculate Theo's total out-of-pocket costs if the estimated hospital bill is $78,019.00, and after the surgery he will require 45 physical therapy visits ($100 each), 10 home health visits ($50 each), 5 physician visits, and 12 specialist visits. (4 points) $11,432.85 $13,425.85 $14,712.85 $18,231.85
Let's break down Theo's estimated out-of-pocket costs for each service type:
Hospital Charges:
Total hospital charges: $78,019.00
Annual deductible for hospital charges: $1,800
Total deductible amount that Theo needs to pay: $1,800
Hospital coinsurance:
15% of the total hospital charges: 0.15 * $78,019.00 = $11,702.85
Total coinsurance amount that Theo needs to pay: $11,702.85
Physical Therapy:
10 physical therapy visits at $20 each: 10 * $20 = $200
Remaining physical therapy visits: 45 - 10 = 35
Coinsurance for the remaining visits (20% of each visit): 0.2 * $100 * 35 = $700
Total physical therapy costs that Theo needs to pay: $200 + $700 = $900
Home Health Visits:
10 home health visits at $50 each: 10 * $50 = $500
Remaining home health visits: 5
Coinsurance for the remaining visits (30% of each visit): 0.3 * $50 * 5 = $75
Total home health costs that Theo needs to pay: $500 + $75 = $575
Physician Visits:
5 physician visits with a $15 copayment each: 5 * $15 = $75
Total physician costs that Theo needs to pay: $75
Specialist Visits:
12 specialist visits with a $40 copayment each: 12 * $40 = $480
Total specialist costs that Theo needs to pay: $480
Emergency Room:
Emergency room copayment: $50
Total emergency room costs that Theo needs to pay: $50
Ambulance:
Ambulance copayment: $500
Total ambulance costs that Theo needs to pay: $500
Now, let's calculate the total out-of-pocket costs for Theo:
Total out-of-pocket costs = Deductible + Coinsurance + Physical Therapy costs + Home Health costs + Physician costs + Specialist costs + Emergency Room costs + Ambulance costs
Total out-of-pocket costs = $1,800 + $11,702.85 + $900 + $575 + $75 + $480 + $50 + $500
Total out-of-pocket costs = $13,082.85
Therefore, Theo's total out-of-pocket costs will be $13,082.85.