Question

Ask a relative or friend about their policy and complete the Table below. (either company is fine)

Comparison: Out-of-Pocket Costs by Healthcare Insurance

Company

Type of Cost	Example	Healthcare Co. A
Annual Premium (Monthly x 12)	$56 x 12 = $672 (Individual)
Annual Deductibles	$350 per Covered Individual
Drugs	$0
Physician Office Visits	Inc. in $350
Inpatient	Inc. in $350
Outpatient	Inc. in $350
Mental Health	Inc. in $350
Outpatient Therapy (PT, OT, Speech)	Inc. in $350
Chiropractic	Inc. in $350
Other
Co-Payments
Dental	$15 per Visit for Accident, Routine Not Covered
Drugs	Each 34-Day Supply: $10 Generic, $25 Preferred Brand without Generic, $40 Preferred Brand with Generic, $50 Non-Preferred Brand ($10 Generic x 12 mos. = $120)
Physician Office Visits	$15 per Visit ($15 x 4 Visits per Year = $60)
Inpatient	$150 per Admission
Mental Health	$150 Inpatient Care, $15 per Visit, $100 Treatment Admission
Outpatient Therapy (PT, OT, Speech)	$15 per Visit
Chiropractic	$15 per Visit
Outpatient Hospital or Amb. Surg.	$75 per Episode
Emergency Room	$200 per Visit (Unless Admitted)
Vision	$15 per Medical Eye Exam, Glasses etc. Not Covered
Other
Coinsurance	20% up to $2,000 per Member
Inpatient	See 20% above
Outpatient	See 20% above
Other
Ambulance	Prior Approval
Home Care	Prior Approval
Private Duty Nurse	Prior Approval
SNF	Prior Approval
Other Out-of-Pocket
TOTAL	$1,202 before Lab Work or X-rays (4 clinic visits and generic meds)

Answer 1

My friends policy :-

- Annual premium ( monthly ×12) = $75×12 = $ 900( individual)

- Annual deductible = $400 per covered individual

- Drugs = $ 100

- Physician office visit= $ 200

- inpatient=$ 200 inc.

- outpatient =$200 inc.

- mental health = $200inc.

- outpatient therapy =$200 inc.

- chiropractic =$200 inc.

- Drugs = $ 20 for generic , 35 $ for preferred brand

- Dental =$30 for accident and dental diseases not for routine check up

- Outpatient hospital or Amb. Surg.= $ 65 per visit

-Emergency room =$ 300 per visit

- Vision =$20 per visit ( 20$×2 =$40)

-Ambulance = prior approval

- Home care = prior approval

- Private duty nurse = prior approval

- SNF= vprior approval

- Total = $ 1890 before lab work or X-ray