How much will a patient pay out of pocket for a $180 minor procedure if the patient chooses to self-insure?

Table shows Dental Insurance with Preventative Exam at 100%, Minor Restorative at 80%, Major Restorative at 50%, Deductible at $100, Maximum Benefit at $2200, and Monthly Premium at $70.

Dollar sign blank. Fill in the blank.


To determine how much a patient will pay out of pocket for a $180 minor procedure if they choose to self-insure, we need to compare the costs between being insured and self-insuring.

### 1. **Cost with Insurance**:
- **Minor Restorative Coverage**: 80% of $180
- **Insurance Pays**: $ 0.80 \times 180 = 144 $ dollars
- **Patient Pays**: $ 180 - 144 = 36 $ dollars

However, we must also consider the deductible:
- **Deductible**: $100
- Since the procedure cost is less than the deductible, the patient must pay the full deductible before insurance coverage kicks in. So, the patient will pay the deductible, which is $100.

### 2. **Total Cost with Insurance**:
- **Out of Pocket**: $100 (deductible) + $70 (monthly premium) = $170

### 3. **Cost without Insurance (Self-Insure)**:
- The patient would pay the full cost of the procedure: $180.

### **Comparison**:
- **With Insurance**: $170
- **Self-Insure**: $180

### **Answer**:
If the patient chooses to self-insure, they will pay $180 out of pocket.

Would you like further details or have any questions? 

Here are 5 related questions for further exploration:
1. What would the cost be for a major restorative procedure under the same insurance plan?
2. How does the insurance maximum benefit of $2200 affect overall costs?
3. What would happen if the patient had already met their deductible?
4. How does self-insurance compare over a year with regular minor procedures?
5. How does choosing a different insurance plan affect the total cost?

**Tip:** Always consider the deductible and maximum benefit when evaluating insurance plans for frequent medical or dental expenses.

How much will a patient pay out of pocket for a $180 minor procedure if the patient chooses to self-insure?

Determine the out-of-pocket cost for a $180 minor procedure under self-insurance and insurance plans. This problem involves percentage calculations, cost comparisons, and deductible considerations. Suitable for high school students exploring financial literacy.

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