Module 5 Practice Problems

For problems 5.1-5.4, use the following insurance coverage. Assume a copay must be paid at each visit. For each calculate the total patient responsibility for the year and the total insurance company responsibility for the year.

• $50 copay
• $1,000 deductible
• 90/10 coinsurance after deductible

Problem 5.1

• January 30: $300
• March 18: $100
• May 7: $200
• October 10: $250
• December 4: $350

Answer: You pay $1,200, they pay $0

Problem 5.2

• April 4: $50
• December 8: $15,000

Answer: You pay $2,495, they pay $12,555

Problem 5.3

• January 8: $500
• February 4: $700
• April 30: $600
• June 3: $900
• August 3: $1,500
• September 16: $700
• November 30: $1,200
• December 15: $900

Answer: You pay $1,960, they pay $5,040.

Problem 5.4

• February 6: $200
• June 12: $500
• September 9: $300
• November 1: $200
• December 10: $400

Answer: You pay $1,285, they pay $315.

For problems 5.5-5.7, determine which of the following plans is the best (anticipated) option for each person.

Gold Plan

• $350/month
• $100 deductible
• No coinsurance

Silver Plan

• $200/month
• $1,000 deductible
• 90/10 coinsurance after deductible

Bronze Plan

• $50/month
• $2,500 deductible
• 80/20 coinsurance after deductible

Problem 5.5: Antwon expects to have around $500 in medical bills for the year.

Answers: 4,300; 2,900; 1,100 (pick bronze)

Problem 5.6: Bridget expects to have around $3,500 in medical bills for the year.

Answers: 4,300; 3,650; 3,300 (pick bronze)

Problem 5.7: Chad expects to have around $10,000 in medical bills for the year.

Answers: 4,300; 4,300; 4,600 (pick gold)