Andrew is insured by Leroux Health Insurance under Plan A. The plan includes a $248.00 monthly premium with a $5,500.00 annual deductible (not including co-pays).Andrew is severely asthmatic. He visits his primary care physician twice a month and his asthma specialist once a month. He has two separate generic inhalers that need to be refilled on a weekly basis. To make matters worse, Andrew has recently been diagnosed with appendicitis and is scheduled to have his appendix removed in the morning. The procedure will cost about $1,500. Considering his frequent doctor visits, many prescription refills, and his appendix removal in addition to his monthly premium, how much will Andrew pay in health care related fees this year?Leroux Health InsurancePlan A Cost: Monthly Premium: $248.00 Annual Deductible: $5,500.00 Co-pays: Brand-name Prescriptions $35.00 Generic Prescriptions $15.00 Visits: Primary Care Physician: $40.00 Specialist: $60.00 Urgent Care: $125.00 Emergency Room: $325.00
Andrew’s annual premiums are 12 × $248 = $2,976. His visits cost 24 × $40 = $960 for primary care and 12 × $60 = $720 for specialist care. Two weekly generic refills cost 2 × 52 × $15 = $1,560. The $1,500 appendix procedure is below his $5,500 deductible, so he pays its full cost; adding these amounts gives $7,716, choice D.
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