Liam has purchased a fee-for-service health insurance plan from Leroux Health Insurance. Plan A includes a $248.00 monthly premi
um and an annual deductible of $5,500.00 (not including co-pays). Liam is a fairly healthy young man. He visits his primary care physician three times a year on scheduled visits. He sees a chiropractic specialist every week to help with lower back pain. He has no current prescriptions that need refilling regularly. Assuming Liam maintains his regular visits with his primary care physician and his chiropractor, and avoids any trips to the emergency room or urgent care, how much will Liam pay in health care related fees this year? Leroux Health Insurance Plan A Cost: Monthly Premium: $248.00 Annual Deductible: $5,500.00 Co-pays: Brand-name Prescriptions $35.00 Generic Prescriptions $15.00 Visits: Primary Care Physician: $40.00 Specialist: $60.00 Urgent Care: $125.00 Emergency Room: $325.00 a. $716.00 b. $3,816.00 c. $5,500.00 d. $6,216.00
An annual deductible is how much you have to pay before the insurance kicks in and starts to pay for medical treatment that you receive for example an annual deductible of 2000 means that when every dollar you pay over 2000 its paid or co-paid by the insurance company, so we just need to add up all the medical expenses that Liam would have in a year:
$248 monthly= 2976
52 visits to the chirporactor= 52 weeksx60= $3120
3 visits to the primary care= $40 x 3= $120
Total=$6216
Since the annual deductible is $5,500 once he gets to $5,500 in the year the insurance company starts to pay for him, so he would only have to pay $6216.
