Nick has a comprehensive health care policy with a $250 per calendar year deductible and 80%-20% with a maximum $1,000 copayment cap per calendar year.In January,Nick had a $600 claim which the insurance company paid $280.Nick experiences another unrelated claim in October resulting in total bills of $5,000.How much will Nick have to pay for the second claim?
A) $5,000
B) $3,930.
C) $1,800
D) $ 930.
E) none of the above.

Question

Quizplus · Accepted Answer

Nick has already paid the $250 deductible with the first claim. For the second claim, he pays 20% of the remaining $5,000 until he reaches the $1,000 copayment cap. Since he has already paid $70 towards the copayment cap from the first claim ($350 - $280), he only needs to pay an additional $930 to reach the $1,000 cap.

Nick Has a Comprehensive Health Care Policy with a $250