A financial agreement for the payment of health-related costs that is made between an individual or a group of individuals and an insurance company is known as _____.Fixed IndemnityCoinsuranceHealth insuranceCopayBilly received a claim against his health insurance in the mail in the amount of $4,910. This is the first claim against his health insurance for the current calendar year. His deductible is $3,000, his coinsurance is 20%, and his premium is $200. What will Billy end up paying on this claim?$3,382$4,528$3,582$3,000Raymond pays for the first $2,600 of covered services himself (out-of-pocket) under his health insurance plan. This $2,600 is a known as a _____.CopayDeductiblePremiumCoinsuranceBecky is having foot surgery and lives in a townhouse with four flights of steps. She would like to stay in a long-term care facility for the first couple of weeks following her surgery so as not to be a bother to her family. However, when she inquires about her plans to her health insurance company she is told that the long-term care facility will not be covered for her in this type of situation. This is known as a policy _____.premiumappealexclusiondenialSusie selects a health insurance plan through her employer where she makes a $200 payment in full each month for her health care benefits to remain completely active. This payment is known as:DeductibleCoinsuranceA copayA premium
Question
A financial agreement for the payment of health-related costs that is made between an individual or a group of individuals and an insurance company is known as _____.Fixed IndemnityCoinsuranceHealth insuranceCopayBilly received a claim against his health insurance in the mail in the amount of 3,000, his coinsurance is 20%, and his premium is 3,3823,5822,600 of covered services himself (out-of-pocket) under his health insurance plan. This 2,600 is a known as a _____.CopayDeductiblePremiumCoinsuranceBecky is having foot surgery and lives in a townhouse with four flights of steps. She would like to stay in a long-term care facility for the first couple of weeks following her surgery so as not to be a bother to her family. However, when she inquires about her plans to her health insurance company she is told that the long-term care facility will not be covered for her in this type of situation. This is known as a policy _____.premiumappealexclusiondenialSusie selects a health insurance plan through her employer where she makes a 200 payment in full each month for her health care benefits to remain completely active. This payment is known as:DeductibleCoinsuranceA copayA premium
Solution
A financial agreement for the payment of health-related costs that is made between an individual or a group of individuals and an insurance company is known as health insurance.
To calculate what Billy will end up paying on the claim, we need to consider his deductible and coinsurance. Since his deductible is $3,000, he will need to pay that amount first. After that, his coinsurance of 20% will apply to the remaining amount.
So, the calculation would be as follows: Claim amount: 3,000 Remaining amount: 3,000 = 1,910 = $382
Therefore, Billy will end up paying a total of 382 (coinsurance) = $3,382 on this claim.
The $2,600 that Raymond pays for covered services himself is known as a deductible.
When Becky inquires about her plans to her health insurance company and is told that the long-term care facility will not be covered, this is known as a policy exclusion.
The $200 payment that Susie makes in full each month for her health care benefits to remain completely active is known as a premium.
Similar Questions
Question 16Which of the following correctly matches a cost sharing/OOP spending tool to an example of it?1 pointDeductible- A person has to pay $25 for each doctor visit and insurance will cover the rest. Out-of-pocket maximum (OOP)- After a person’s out-of-pocket spending reaches $3,000 in a calendar year, the insurer will pay all the remaining costs in full. Copayment- A person must pay 30% of medical expenses and insurance will pay the other 70%.Coinsurance- A person pays for the first $500 of health spending and then insurance covers any cost after that.
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Multiple Choice QuestionA provision under which the insured pays a flat dollar amount each time a covered medical service is received is called:Multiple choice question.coinsuranceflat rate paymentcopaymentdeductible
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