Math

Fidel Baez has a health insurance plan with a $150.00 deductible. The plan covers 80 percent of his hospital charges. Fidel's recent health care costs include $300.00 in co-payments and a hospital bill of $2,300.00. What amount did he pay?

Is it $910.00?

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  1. He paid $300 in copayments, so that means that the deductible no longer applies on subsequent payments.

    Out of the $2300 in hospital bill, he has to pay the copayment of 80%
    = 2300*0.80
    = $1840
    added to the previous copayment, he paid a total of
    1840+300 = $2140

    Please explain how you got $910 in case I missed something.

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  2. Hi.
    The PLAN covers 80 percent. Fidel only pays 20% of the hospital charges. The deductible (according to my textbook) is supposed to be added to the amount that he is subjected to pay. (Doesn't make sense to me as deductible should mean that the amount would be reduced.)

    460 (20%)+ 300 (payments)+ 150=910.

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  3. Yes, you're right.
    I misread the 80% as the copayment.

    Most health insurance companies that I have seen have annual deductibles, which I assumed. Here I interpreted that the $300 was a previous payment, which exceeds the annual deductible.

    However, since no mention was made of an annual deductible, it is therefore assumed to be per claim as you did, which makes your calculation valid.

    So he pays
    2300*(1-0.8)+150 + 300
    =$910

    Just in case, double-check with your teacher to see if deductibles for health policies are annual or per claim. The reason for that is most claims are small. With a $150 per claim deductible, the insured will not get much coverage except for hospital stays.

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