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
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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
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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
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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:
- How would the calculations change if one family member had additional expenses?
- What are the implications if a family member’s expenses exceed a certain threshold?
- How does the deductible impact the family’s yearly health costs?
- What happens if the family has a Health Savings Account (HSA) instead of an FSA?
- 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
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