How much money would be deducted from Steve’s pay annually if he chooses Plan B?
$300 x 12 months = $3,600
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
