Paying for Healthcare
Instructions: Steve Smith has a wife and 8 year-old daughter. His wife is a self-employed interior designer and is covered under his company’s insurance plan. Answer the questions based on the insurance options represented in the table below.

Monthly Premium
Deductible
Co-Payment
Co-Insurance
Plan A
$200
$1000 per person
$25 per visit
20%
Plan B
$300
$500 per person
$10 per visit
10%
Plan C
$500
0
0
0

How much money would be deducted from Steve’s pay annually if he chooses Plan B? 3600$

Steve has Plan A health insurance and has met $400 of his deductible. He broke his arm and is charged for one emergency room visit and one office visit. The total bill for his visits, x-ray and treatment is $1425. How much of the cost must Steve pay out of pocket? 935$

How much will his insurance company pay? 490$

Two months later and during the same year, Steve has a colonoscopy. The total cost is $960. How much will Steve need to pay? 217$

In 2008, Steve and his family had a total of $3000 each in medical expenses. Approximately how much would each plan cost Steve if each member of his family (including Steve) had five (5) office visits during the year?
Plan A 7575$
Plan B 6150$
Plan C 6000$
Steve has Plan B. His daughter is hit in the nose by a soft ball during recess at school. The emergency room visit and outpatient surgery to repair her nose costs a total of $1300. If none of his daughter’s deductible has been met and the school agrees to pay for all expenses not covered by insurance, how much will the school end up paying? 660$

Steve has Plan A health insurance and has met $400 of his deductible. He broke his arm and is charged for one emergency room visit and one office visit. The total bill for his visits, x-ray and treatment is $1425.

Total = $1425 ($490 - insurance + $935 - Steve)

Deductible = $1,000 - $400 = $600

Copayment = $25/visit x 2 = $50

Co-Insurance = $1,425 x 0.2 (20%) = $285

How much of the cost must Steve pay out of pocket? $935

How much will his insurance company pay? $490

Two months later and during the same year, Steve has a colonoscopy. The total cost is $960. How much will Steve need to pay?

Total = $960

Deductible = $0 - Already met

Copayment = $25/visit = $25

Co-Insurance = $960 x 0.2 (20%) = $192

Steve Pays: $25 + $192 = $217

In 2008, Steve and his family had a total of $3000 each in medical expenses. Approximately how much would each plan cost Steve if each member of his family (including Steve) had five (5) office visits during the year?

Plan A:

Monthly premium: $200 x 12 months = $2,400

Deductible: $1,000 x 3 people = $3,000

Co-Payment: $25/visit x 3 people x 5 visits each = $375

Co-Insurance: $9,000 (previous expenses per person) x 0.2 (20%) = $1,800

TOTAL: $7,575

Plan B:

Monthly premium: $300 x 12 months = $3,600

Deductible: $500 x 3 people = $1,500

Co-Payment: $10/visit x 3 people x 5 visits each = $150

Co-Insurance: $9,000 (previous expenses per person) x 0.1 (10%) = $900

TOTAL: $6,150

Plan C:

Monthly premium: $500 x 12 months = 6,000

Deductible: $0

Co-Payment: $0

Co-Insurance: $0

TOTAL: $7,575

Steve has Plan B. His daughter is hit in the nose by a soft ball during recess at school. The emergency room visit and outpatient surgery to repair her nose costs a total of $1300. If none of his daughter’s deductible has been met and the school agrees to pay for all expenses not covered by insurance, how much will the school end up paying?

Total = $1,300

Deductible = $500

Total after Deductible = 800

Copayment = $10/visit = $10

Co-Insurance = $800x 0.1 (10%)

Steve Owes: $590 - This is what the school is willing to pay