Jamie Lee bas had good maternity care so far, but they both felt a need to...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
Jamie Lee bas had good maternity care so far, but they both felt a need to review their health insurance policies with the poten- Jamie Lee and Ross, happy newlyweds with a new home and rwins on the way, are anxiousty awaiting their new bundles Joy, Ross was a linle nervous, and understandably s, jas he wondered ir evervihine would go smoothly with Jamie's pregane) Fortunately for them, they coordinated benefits from the medical insurance erout plan offfered by Ross's employmen graphics agency and Jamie Lee's own plan, although Ross's ptan would be their primary. His employer offers a Hicamy Savings Plan, but Ross previously had not realized the need to participale in this benefit. tial of extensive medical expenses just on the horizon. Would their sataries be enough to pay for the expenses that were not coverç or even the deductibles for out-of-network doctors? Current Medical Insurance Provisions Jamie Lee and Ross have a PPO, or Preferred Provider Orgunitation plan. In-Network Medical Care: Jamic Lee and Ross currently have a $15 conayment on regular preventive care doctor visits and a S30 copayment on specialists that are preferred providers or participating members from the PPO plan's list. Out-of-Network Medical Care: Jamie Lee and Ross have the choice of seeking medical care from the professional of their choice outside the PPO member list, but will incur a deductible of $500 per person/S1.000 per family, per year. After the deduct ible is met, there is a coinsurance of 80%/20%, whereas the insurance comupany would cover 80% of the allowable medical fees and the policylholders would be responsible for 20% of the allowable medical fees. Medical fees that are not allowed under the medical plan provisions would be 100% the policyholder's responsibility. Out-of-Pocket Limits: Their health insurance plan provides an out-of-pocket limit of S75.000 per year. Questions 1 Using the text as a guide, list some of the strategies that Ross and Jamie Lee can use to better prepare financially for the arrival of the twins. 2. How could Jamie Lee and Ross prepare for the birth of the twins with their existing PPO plan? 3. Jamie Lee and Ross learned that the hospital that they plan to use for the delivery is not a participating hospital. What will their financial responsibility be for the nonparticipating hospital expenses? 4 The doctor's office has estimated the hospital expense for Jamie Lee and the babies' delivery, without complications, to be approximately $18.000. Based on their health insurance policy, how much would Jamie Lee and Ross owe for this out-of- network hospital stay? 5. Surprise! The babies arrived five weeks carly and Jamic Lee and Ross are the proud parents of triplets! There are two boys and a girl, and as they were pre-term, they will neced to spend a few extra days in the hospital for observation. How will Ross and Jamie Lee make provisions for adding the babies to their health insurance policy now that they have arrived? Jamie Lee bas had good maternity care so far, but they both felt a need to review their health insurance policies with the poten- Jamie Lee and Ross, happy newlyweds with a new home and rwins on the way, are anxiousty awaiting their new bundles Joy, Ross was a linle nervous, and understandably s, jas he wondered ir evervihine would go smoothly with Jamie's pregane) Fortunately for them, they coordinated benefits from the medical insurance erout plan offfered by Ross's employmen graphics agency and Jamie Lee's own plan, although Ross's ptan would be their primary. His employer offers a Hicamy Savings Plan, but Ross previously had not realized the need to participale in this benefit. tial of extensive medical expenses just on the horizon. Would their sataries be enough to pay for the expenses that were not coverç or even the deductibles for out-of-network doctors? Current Medical Insurance Provisions Jamie Lee and Ross have a PPO, or Preferred Provider Orgunitation plan. In-Network Medical Care: Jamic Lee and Ross currently have a $15 conayment on regular preventive care doctor visits and a S30 copayment on specialists that are preferred providers or participating members from the PPO plan's list. Out-of-Network Medical Care: Jamie Lee and Ross have the choice of seeking medical care from the professional of their choice outside the PPO member list, but will incur a deductible of $500 per person/S1.000 per family, per year. After the deduct ible is met, there is a coinsurance of 80%/20%, whereas the insurance comupany would cover 80% of the allowable medical fees and the policylholders would be responsible for 20% of the allowable medical fees. Medical fees that are not allowed under the medical plan provisions would be 100% the policyholder's responsibility. Out-of-Pocket Limits: Their health insurance plan provides an out-of-pocket limit of S75.000 per year. Questions 1 Using the text as a guide, list some of the strategies that Ross and Jamie Lee can use to better prepare financially for the arrival of the twins. 2. How could Jamie Lee and Ross prepare for the birth of the twins with their existing PPO plan? 3. Jamie Lee and Ross learned that the hospital that they plan to use for the delivery is not a participating hospital. What will their financial responsibility be for the nonparticipating hospital expenses? 4 The doctor's office has estimated the hospital expense for Jamie Lee and the babies' delivery, without complications, to be approximately $18.000. Based on their health insurance policy, how much would Jamie Lee and Ross owe for this out-of- network hospital stay? 5. Surprise! The babies arrived five weeks carly and Jamic Lee and Ross are the proud parents of triplets! There are two boys and a girl, and as they were pre-term, they will neced to spend a few extra days in the hospital for observation. How will Ross and Jamie Lee make provisions for adding the babies to their health insurance policy now that they have arrived?
Expert Answer:
Answer rating: 100% (QA)
1 In the PPO plan Ross can take the out of network medical care for 10... View the full answer
Related Book For
Andersons Business Law and the Legal Environment
ISBN: 978-1133587583
22nd edition
Authors: David P. Twomey, Marianne M. Jennings
Posted Date:
Students also viewed these organizational behavior questions
-
Cepat Sdn. Bhd. (CSB) produces a liquid fertiliser for local farmers. The fertiliser is made in two consecutive production processes. The cost accountant has provided the following information for...
-
Jamie Lee and Ross need to evaluate their emergency fund of $21,000. Will their present emergency fund be sufficient to cover them should one of them lose their job? Show the equation for calculating...
-
1. As Jamie Lee and Ross review their assets, can you tell them which will be valuable to them for income as retirement approaches? 2. Jamie Lee and Ross estimate that they will have one million...
-
1. Insurance Act, RSBC 1996 c226 Read Parts 1 and 2 of this statute and describe any changes to the standard commonlaw rules for contracts that you notice. 2. KP Pacific Holdings Ltd. and Churchland...
-
Explain Bernanke's solutions to help address growing income inequality. Ben Bernanke, the chairman of the Federal Reserve, said that increased education opportunities would help reduce the increased...
-
Regional Supermarket is open 360 days per year. Daily use of cash register tape averages 10 rolls. Usage appears normally distributed with a standard deviation of 2 rolls per day. The cost of...
-
Refer to the information in QS 19-16. The company sells its product for $50 per unit. Due to new regulations, the company must now incur $2 per unit of hazardous waste disposal costs and $8,500 per...
-
Fulco Company engaged in the following transactions in March 2014: Mar. 7 Sold merchandise on credit to James William, terms n/30, FOB shipping point, $3,000 (cost, $1,800). 8 Purchased merchandise...
-
Calculate inventory amounts when costs are declining During the year, Hooker Incorporated has the following inventory transactions. Date January 1 Transaction Beginning inventory March 4 Purchase...
-
Background: A new ownership group has recently purchased ABC Liquors. You have been hired by the new management team to analyze their sales data for the past year and provide them with insights about...
-
Elaborate on the procedure to estimate the height of the reflected wave from coastal structure, including the correction for nonlinear waves and slope.
-
A rainfall storm precipitated in an area shown in the figure. below, the recorded rainfall depth in each station was as below: PA= 35 mm, PB 33 mm Pc= 38 mm, P=39 mm, and PE 43. Find: 1- Average rain...
-
Atita plans to gift $150,000 to her daughters as a gift in the future. She thinks it will help her daughter fulfil her dreams when she reaches her age to marry. Assume her daughter is 3 years old and...
-
On June 30, Max and Chub formed a partnership called "Magnus Opus Partnership". The partners agreed to invest equal amounts of capital. Max invested his proprietorship's assets and liabilities as...
-
Figure 5 shows a metal cutter that used to cut the cable at C. The jaws J are pinned at E, A, D and B. There is also a pin at F. (a) Determine the force developed on the cable at C and pin A if force...
-
Is it accurate to assert that infertility solely arises from pathological conditions affecting the reproductive organs?
-
Ethos is a Greek word associated with how one lives:wt A. Their individual life (personal integrity) B. Within a community (social responsibility) C. Both A & B D. Neither A nor B 2 points ...
-
The maximum pressure that can be developed for a certain fluid power cylinder is 15.0 MPa. Compute the required diameter for the piston if the cylinder must exert a force of 30 kN.
-
TLC was an Atlanta rhythm, blues, and hip-hop band that performed at clubs in 1991. The three-woman group signed a recording contract with LaFace Records. The groups first album that LaFace produced,...
-
The Eminem ad for Chrysler that ran during the Super Bowl in February 2011 was rated as one of the best ads for the game. In May 2011, Audi ran an ad at a German auto show that had the feel of the...
-
David Ungar holds a Dunkin Donuts franchise. The terms of his franchise agreement require him to use only those ingredients furnished by Dunkin Donuts. He is also required to buy it snap kins, cups,...
-
Consider a sample taken from the population of all taxi-in times for all flights that land in Los Angeles. Identify the symbols used for the sample standard deviation, the population standard...
-
An article in the New York Times noted that these new ZIP codes were created in New York City: 10065, 10021, 10075. Find the mean of these three numbers. What is fundamentally wrong with this result?
-
Shown below is a boxplot of a sample of 20 brain volumes (cm 3 ). What do the numbers in the boxplot represent? 963 1034.5 1079 1439 1188.5
Study smarter with the SolutionInn App