Question

The health care Jimmy’s employer offers is a fee-for-service plan in which Jimmy and his family must pay for $12,500 in health related services in a calendar year before the insurance company begins to pay. Jimmy and his family have several health related issues that demand $685.00 each month. If one of Jimmy’s children were to become seriously injured at the end of the year, how much would the related health costs need to be in order for the insurance company to assume responsibility? a. $984.58 b. $4,280.00 c. $11,815.00 d. $14,417.92

Answer 1

First of all, let's find what the monthly $685 amounts to after a year. $685 x12 = $8,220. After one year, the family will have spent $8,220 for healthcare. However, the threshold of $12,500 must be reached before claiming any payment from insurance. Therefore, the costs related to Jim's seriously injured child will have to amount to: $12,500 - $8,220 = $4,280. The cost to bear in relation to Jim's injured child must be $4,280 or else he won't be able to claim any refund.