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 $ 833​, $ 1 comma 895​, and $ 188​, ​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 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. B. 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.

Solution

To solve the expenses problem, let’s break down the Baulding family's out-of-pocket costs and the insurance company's contribution after the deductibles. Each family member has a $250 deductible, and the insurance covers 80% of out-of-hospital expenses after deductibles.

1. Calculate the expenses and payments for each family member

  1. Family member with $833 in expenses:

    • Deductible: $250
    • Remaining amount after deductible: $833 - $250 = $583
    • Insurance payment (80% of $583): $583 * 0.80 = $466.40
    • Family payment: $250 (deductible) + $116.60 (20% of the remaining) = $366.60
  2. Family member with $1,895 in expenses:

    • Deductible: $250
    • Remaining amount after deductible: $1,895 - $250 = $1,645
    • Insurance payment (80% of $1,645): $1,645 * 0.80 = $1,316
    • Family payment: $250 (deductible) + $329 (20% of remaining) = $579
  3. Family member with $188 in expenses:

    • Total expenses ($188) are less than the deductible ($250), so the family pays all of it.
    • Family payment: $188

2. Total Family Payment and Insurance Payment

  • Family total payment: $366.60 + $579 + $188 = $1,133.60, rounded to $1,134
  • Insurance total payment: $466.40 + $1,316 = $1,782.40, rounded to $1,782

So, the Baulding family will pay $1,134, and the insurance company will pay $1,782.


Part 3: Flexible Spending Account Benefits

A flexible spending account (FSA) can offer benefits by allowing the Bauldings to pay for healthcare expenses that aren’t covered by insurance, such as deductibles and co-pays, using pre-tax dollars. This can reduce taxable income and increase savings.

Best Choice:

  • Choice A is best, as it describes the primary advantage of using pre-tax dollars and mentions the "use it or lose it" policy, a potential downside if contributions aren't fully spent.

Would you like more details on each step, or do you have specific questions?

Relative Questions to Explore Further:

  1. How would the calculations change if one family member had additional expenses?
  2. What are the implications if a family member’s expenses exceed a certain threshold?
  3. How does the deductible impact the family’s yearly health costs?
  4. What happens if the family has a Health Savings Account (HSA) instead of an FSA?
  5. How do similar insurance plans handle out-of-pocket maximums?

Tip:

FSAs are typically limited to a yearly contribution cap, so it’s essential to estimate anticipated expenses to avoid losing unused funds.

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Math Problem Analysis

Mathematical Concepts

Percentage
Deductible Calculations
Out-of-pocket Expenses

Formulas

Remaining amount after deductible = Total expenses - Deductible
Insurance payment = Remaining amount * 80%
Family payment = Deductible + (Remaining amount * 20%)

Theorems

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Suitable Grade Level

Grades 10-12