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hapter 15 Homework. There WILL be at least eleven (11) hom

hapter 15 Homework. There WILL be at least eleven (11) hom

Question
Chapter 15 Homework.
There WILL be at least eleven (11) homework assignments. So the lowest homework grade will be dropped. If you choose not to do one of the homework assignments, that one is the dropped grade. 🙂
Review Questions #1 (2pts) and #2 (3pts) = 5 points
Application Questions #1 (3pts) and 2 through 4 (each 2pts) = 9 points
Total 14 points
* Review Questions

1. Describe briefly the major health-care problems in the United States.

Major problems that lead to enactment of the patient Protection and Affordable Care Act in March 2010 include the following

* Rising health –care expenditures

* Large number of uninsured in the population

* Uneven quality of medical care

* Considerable waste and inefficiency

* Defects in financing health care

Abusive insurer practices

2. Identify the major provisions of the Affordable Care Act that will have an impact on individuals and families.

* Application Questions

1. Mark, age 28, is insured under an individual medical expense policy that is part of a preferred provider organization (PPO) network. The policy has a calendar –year deductible of $1000, 75/25percent coinsurance, and an annual out-of pocket limit of $2000. Mark recently had outpatient arthroscopic surgery on his knee, which he injured in a skiing accident. The surgery was performed in an outpatient surgical center. Mark incurred the following medical expenses. (Assume that the charges shown are the charges approved by Mark’s insurer and that all providers are in the PPO network)

Outpatient X-rays and diagnostic tests $800

Covered charges in the surgical center $12,000

Surgeon’s fee $ 3,000

Outpatient prescription drugs $ 400

Physical therapy expenses $ 1,200

In addition, Mark could not work for two weeks and lost $2000 in earnings.

a. Based on the above information, how much of the expenses will be paid by the insurance company?

b. How much of the expenses will Mark have to pay?

Explain your answer

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