Question

Sarah’s comprehensive major medical health insurance plan at work has a deductible of $550. The policy pays 85 percent of any amount above the deductible. While on a hiking trip, she contracted a rare bacterial disease. Her medical costs for treatment, including medicines, tests, and a six-day hospital stay, totaled $9,460. A friend told her that she would have paid less if she had a policy with a stop-loss feature that capped her out-of-pocket expenses at $3,400. The policy with the stop-loss feature has the same deductible and coinsurance requirement as Sarah's current policy. Determine which policy would have cost Sarah less and by how much. (Round your intermediate calculations and final answer to 2 decimal places.)

Difference amount:

Answer 1

Sarah’s friend was not right.

With stop-loss Sarah would have paid the first $3,400.

She paid $1,513.5 less with her current policy.

Current policy: $9460 – $550 = $8,910 x .15 (percentage Sarah must pay) = $1,336.5 + $550 (deductible)

Total Sarah paid = $1,886.5