Find the (a) deductible, (b) co-payment amount, (c) hospital charges, and (d) total paid by the insured.
Health Care Benefits Schedule
Network Non-Network
Annual Deductible Single $1000 $1500
Family $3000 $4500
Hospital Charges 10% 30%
Co-insurance/Co-payments Physician visit $20 $30
Specialist visit $30 $40
Physical Therapy 20% 30%
Retail Pharmacy Generic $10
Brand-Name $20
Mail-Order Pharmacy (90 day supply) Generic $25
Brand-Name $50
Emergency Room $100 $100
Ambulance $100 $100
Non-Network refers to a health care provider who does not have a contract with the health plan administrator.
Sofia Carbondale has a network single plan. After meeting her annual deductible, she had these co-payments: 18 physician visits, 15 specialist visits, and 15 physical therapy visits at $90 each. Sofia also had 1 emergency room visit and a hospital charge of $24,560.
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