Your health care coverage is with a PPO. For approved, inminusnetwork providers your deductible is $500 and your coinsurance provision is 80%. For outminusofminusnetwork providers, your deductible is $1,000 and your coinsurance provision is 70%. Assume there is no cominuspay provision and you have no other claims this calendar year. You have decided to go to a specialist that is not in the network and the bill is $1,400. How much will you have to pay outminusofminus pocket?

Question

Malia Williams

Business

9 October, 05:34

Your health care coverage is with a PPO. For approved, inminusnetwork providers your deductible is $500 and your coinsurance provision is 80%. For outminusofminusnetwork providers, your deductible is $1,000 and your coinsurance provision is 70%. Assume there is no cominuspay provision and you have no other claims this calendar year. You have decided to go to a specialist that is not in the network and the bill is $1,400. How much will you have to pay outminusofminus pocket?

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Answers (1)

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Marley Jarvis · Answer 1

Answer = $1420

Explanation:

Bill = $1400

Provision for Out-of-Network providers = 70% = $980

$1400 - $980 = $420

Out of network decuctible amount = $1000

$420 + $1000 = $ 1420.

Answer = $1420

But if you directly go to the doctor without opting for co insurance, you can save $20 and this out of network provision can be used in the future, if needed