Question

4. Holly Hiker is insured by an HMO whose network is exclusive to her home city in Pennsylvania. The HMO expects patients to pay any costs up front when accessing healthcare services out of network; the patient then submits the charges for 80 percent reimbursement except in emergency cases when 100 percent is reimbursed. She had a life threatening injury while on a hiking vacation in Maine. She received treatment at the local trauma center's emergency room that cost $1,732. What amount must Holly pay to the hospital in Maine? What amount will Holly be reimbursed by her HMO?