1. Health Insurance Benefits pp. 375-377 11-2 SECTION

2. Click to edit Master text styles Second level Third level Fourth level Fifth level 2 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 2 of 16 11-2 deductible (p. 375) An amount of money someone with insurance must pay before the insurance company pays anything. co-insurance (p. 375) A percentage of medical expenses a person with health insurance must pay beyond the deductible. Key Words to Know

3. Click to edit Master text styles Second level Third level Fourth level Fifth level 3 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 3 of 16 11-2 co-payment (p. 375) An amount a person with health insurance must pay for a service, such as a prescription or a doctor’s visit, along with the insurance company. Key Words to Know

4. Click to edit Master text styles Second level Third level Fourth level Fifth level 4 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 4 of 16 11-2 Amount Paid by Patient = Deductible + Co-payments + Co-insurance Amount + Hospital Charges Formula

5. Click to edit Master text styles Second level Third level Fourth level Fifth level 5 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 5 of 16 11-2 Brooke Burk is single and has a health insurance plan with the benefits shown in Figure 11.1 on page 376 of your textbook. Her recent network health costs include co- payments for 8 physician visits and 9 specialist visits. Example 1

6. Click to edit Master text styles Second level Third level Fourth level Fifth level 6 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 6 of 16 11-2 Following hospital surgery, she made co- payments for 12 physical therapy visits, and she had 75 home visits from a nurse at $55 each. The hospital admission charge was $200, and her hospital bill was $14,560. What amount did she pay? Example 1 (cont.)

7. Click to edit Master text styles Second level Third level Fourth level Fifth level 7 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 7 of 16 11-2 Find the deductible. The deductible is $300. Example 1 Answer: Step 1

8. Click to edit Master text styles Second level Third level Fourth level Fifth level 8 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 8 of 16 11-2 Find the cost of the co-payments. Physician + Specialists + Physical Therapy ($10 × 8) + ($20 × 9) + ($15 × 12) $80 + $180 + $180 = $440 Example 1 Answer: Step 2

9. Click to edit Master text styles Second level Third level Fourth level Fifth level 9 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 9 of 16 11-2 Find the co-insurance amount for home health care. (Note: Co-insurance requires the insurance company to pay 80 percent of the costs and the patient pays 20 percent of the costs.) $55 × (75 – 50) × 20% $55 × 25 × 20% = $275 Example 1 Answer: Step 3

10. Click to edit Master text styles Second level Third level Fourth level Fifth level 10 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 10 of 16 11-2 Find the hospital charges. (Note: The patient pays a small percent of the hospital charge, such as 10 percent.) $14,560 × (100% – 90%) $14,560 × 10% = $1,456 Example 1 Answer: Step 4

11. Click to edit Master text styles Second level Third level Fourth level Fifth level 11 SECTION Copyright © Glencoe/McGraw-Hill MBA, Section 11-2, Slide 11 of 16 11-2 Find the amount paid by patient. Deductible + Co-payment + Co-insurance + Hospital Amount Charges $300 + $440 + $275 + ($1,456 + $200) = $2,671 Example 1 Answer: Step 5

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