Math Problem Statement

The Baulding family has a basic health insurance plan that pays 80 percent of​ out-of-hospital expenses after a deductible of $ 250 per person. If three family members have doctor and prescription drug expenses of $ 943​, $ 1 comma 870​, and $ 200​, ​respectively, how much will the Baulding family and the insurance company each​ pay? How could they benefit from a flexible spending account established through Mr.​ Baulding's employer? What are the advantages and disadvantages of establishing such an​ account? Question content area bottom Part 1 The Baulding family will pay ​$

enter your response here. ​(Round to the nearest​ dollar.) Part 2 The insurance company will pay ​$

enter your response here. ​(Round to the nearest​ dollar.) Part 3 How could they benefit from a flexible spending account established through Mr.​ Baulding's employer? What are the advantages and disadvantages of establishing such an​ account?  ​(Select the best choice​ below.) A. A flexible spending account offers the Bauldings the advantage of paying for all health care expenses with​ pre-tax dollars. The only disadvantage is not having the use of your money all year. B. A flexible spending account offers the Bauldings the advantage of paying for health care expenses not covered by insurance​ (such as unreimbursed medical or dental expenses including​ co-pays to​ doctors, deductibles, and qualified child​ care) with​ pre-tax dollars. Disadvantages include the​ "use it or lose​ it" feature of the​ plan; any contributions to the flexible spending account not used by the end of the year are lost.

Solution

Let's break down the expenses and calculate what the Baulding family and the insurance company will pay.

Part 1: The Baulding Family's Share

  1. Individual Medical Expenses:

    • Family Member 1: $943
    • Family Member 2: $1,870
    • Family Member 3: $200
  2. Deductible Applied (per person):

    • Each family member must pay the first $250 of their expenses before insurance covers 80%.
  3. Calculating Out-of-Pocket Expenses for Each Member:

    • Family Member 1:

      • Total expenses = $943
      • Deductible = $250
      • Remaining amount = $943 - $250 = $693
      • Insurance covers 80% of $693 = $554.40
      • Family Member 1 pays: $250 + (20% of $693) = $250 + $138.60 = $388.60
    • Family Member 2:

      • Total expenses = $1,870
      • Deductible = $250
      • Remaining amount = $1,870 - $250 = $1,620
      • Insurance covers 80% of $1,620 = $1,296
      • Family Member 2 pays: $250 + (20% of $1,620) = $250 + $324 = $574
    • Family Member 3:

      • Total expenses = $200
      • Deductible = $250 (since $200 is less than the deductible, insurance doesn't cover any amount)
      • Family Member 3 pays the entire $200.
  4. Total Out-of-Pocket Costs for the Baulding Family:

    • $388.60 + $574 + $200 = $1,162.60 (rounded to $1,163)

Part 2: The Insurance Company's Share

  1. For Family Member 1, insurance covers $554.40.

  2. For Family Member 2, insurance covers $1,296.

  3. For Family Member 3, insurance pays $0 (no amount remaining after deductible).

  4. Total Insurance Payment:

    • $554.40 + $1,296 = $1,850.40 (rounded to $1,850)

Final Answer:

  • The Baulding family will pay: $1,163
  • The insurance company will pay: $1,850

Part 3: Benefits and Drawbacks of a Flexible Spending Account (FSA)

Answer:

The best choice here is B. An FSA would allow the Bauldings to pay for health care expenses not covered by insurance (such as co-pays, deductibles, and other medical expenses) with pre-tax dollars. The primary disadvantage is the "use it or lose it" policy, meaning any money left in the FSA at the end of the year will be forfeited.


Do you want more details or have questions? Here are some related questions to explore:

  1. How do pre-tax contributions to an FSA increase take-home pay?
  2. What is the annual limit for FSA contributions?
  3. Can unused FSA funds be rolled over to the following year in some plans?
  4. How would a health savings account (HSA) compare to an FSA for the Bauldings?
  5. Are there restrictions on what can be paid using an FSA?

Tip: FSAs can be a great way to manage predictable healthcare costs, but careful planning is essential due to the "use it or lose it" policy.

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Math Problem Analysis

Mathematical Concepts

Insurance Deductibles and Percentages
Basic Arithmetic Operations

Formulas

Out-of-pocket cost = Deductible + (20% of remaining amount after deductible)
Insurance payment = 80% of remaining amount after deductible

Theorems

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Suitable Grade Level

Grades 10-12