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.

1. 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 _____.A. Fixed IndemnityB. CoinsuranceC. Health insuranceD. Copay2.Billy 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?A. $3,382B. $4,528C. $3,582D. $3,0003.Raymond 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 _____.A. CopayB. DeductibleC. PremiumD. Coinsurance4.Becky 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 _____.A. premiumB. appealC. exclusionD. denial5.Susie 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:A. DeductibleB. CoinsuranceC. A copayD. A premium

.Question 18Assume a patient has an upcoming medical procedure that will cost $1000. Suppose the patient is in a health plan with a $500 deductible, after which 20% coinsurance applies. Suppose that the patient has previously had $2000 in health care expenses in the year. How much can the patient expect to pay out of pocket for this procedure? $_______Please write the answer in numeric form. No need to add a dollar sign.

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

Which is the best example of an out-of-pocket cost?A.A deductibleB.A repair estimateC.A claimD.A benefitSUBMITarrow_backPREVIOUS

There is an insurance company and three customers, Alice, Bob and John. The timing is as follows.(1) The insurance company announces the premium and excess of a health insurance policy.(2) At Date 1, each customer decides whether to purchase the health insurance policy.(3) At Date 2, each customer will discover their health status, which is either G (healthy) or B (needing treatment inhospital).(4) Nothing happens if a customer is healthy. If a customer needs treatment in hospital, then they pay $10,000 if theydo not hold a health insurance or the excess of the policy if they do. They are cured after treatment in hospital.For simplicity, assume that the insurance company is a monopolist.Each customer has the following utility index: 𝑢(−𝑥1) + 11.02 𝑢(−𝑥2), where 𝑥𝑡 is the payment (either to the insurancecompany or to the hospital) at Date 𝑡 and 𝑢(−𝑥) = 40000√1 − (𝑥∕20000) − 40000. Table 1 summarizes each customer’sage and probability of remaining healthy.Name Age Probability of GAlice 25 99.5%Bob 25 98%John 60 95%(a) First, assume that the insurnace company offers the policy with premium $210 and excess $750. Who would like tobuy this policy? (You should find that Bob and John would like to buy the policy.)(b) David is also 25 years old and will remain healthy with probability 98% at Date 2. Unlike Bob, David’s utility indexis −𝑥1 + 11.02 (−𝑥2). Show that David does not want to buy the insurance policy in (a).(c) Note that David and Bob are equally healthy, what makes one buy the insurance policy and the other does not?(d) Next, assume that the insurance company offers the policy with premium $530 and excess $500. Who would like tobuy this policy?(e) From the insurance company’s perspective, describe the potential problem of selling only one of the two policies in(a) and (d)