Question
MTOP Inc.offers its employees the choice between a private insurance company plan (Blue Cross/Blue Shield), an HMO, and a POS. Ronald needs to review the
MTOP Inc.offers its employees the choice between a private insurance company plan (Blue Cross/Blue Shield), an HMO, and a POS. Ronald needs to review the packet and make a decision on which health care program fits his needs. The following is an overview of that information.
- Blue Cross/Blue Shield plan:The monthly premium cost to Ronald will be $49. For all doctor office visits, prescriptions, and major medical charges, Ronald will be responsible for 35 percent of covered charges and the insurance company will cover the rest. The annual deductible is $350.
- HMO Plan:The HMO is provided to employees free of charge. The copayment for doctors' office visits and major medical charges is $35. Prescription copayments are $15. The HMO pays 100 percent after theRonald's copayment. No annual deductible.
- POS Plan:The POS requires that the employee pay $28.94 per month to supplement the cost of the program with the company's payment. If Ron uses health care providers within the plan, he pays the copayments as described above for the HMO. He can also choose to use a health care provider out of the service and pay 15 percent of all charges after he pays a $350 deductible. The POS will pay for 85 percent of those covered visits. No annual deductible.
Ronald decided to review his medical bills from the previous year to see what costs he had incurred and to help him evaluate his choices. He visited his general physician 3 times during the year at a cost of $160 for each visit. He also spent $75 and $120 on prescriptions during the year.
What annual medical costs will Ronald pay using the sample medical expenses provided if he were to enroll in the Blue Cross/Blue Shield plan?
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