Explanation of Benefits

PatchUp to the Rescue!

Sometime after Bobby gets his cast off, a letter arrives in the mailbox. Mr. Bones notices it’s from PatchUp, the Bones’ health plan. He opens it up nervously. It turns out that it’s PatchUp’s  explanation of benefits (a statement you receive in the mail describing what your health insurance did and didn’t cover). Mr. Bones pours his eyes over the document.

It turns out that if Bobby Bones was uninsured, the ER would cost $1000, the first appointment with Dr. Joints would cost $100, the appointment to put in the cast would cost $400, and the appointment to take the cast off would be $100. That makes a grand total of $1,600 if the Bones’ did not have health insurance.

However, all the services used to fix Bobby up were in-network providers that have a deal with PatchUp. So, the contracted rate of the ER visit is now $500, the first appointment is $50, the second appointment $300, and the last appointment $50. That makes a grand total of $900 (plus the copayment of $140). “Well, that’s a little bit better,” thinks Mr. Bones, “But I still think we could save some more money.” Hold on there, Boney.