Health Coverage Comparison

CHAPTER 9, LESSON 4

NAME(S) DATE
Aubrey 4/24/24

DIRECTIONS
Use the Health Plan Comparison Sheet to calculate the total out-of-pocket medical expense for each insurance
plan, Health Choice and Super Health, and record your answers in the chart. When you begin, your deductible
has not been met. The fee listed next to each item is the cost of that service without any health insurance.

COST WITH COST WITH

SERVICE AND COST
HEALTH CHOICE SUPER HEALTH

1. Doctor’s office visit for a sore throat and cough

5 95
(in network) $95

2. Emergency room for stitches (in network) $115 25 115

DEDUCTIBLE NOW MET

3. Appendectomy (in network)

» Surgery $14,000
10 7
» Two-night hospital stay $2,000
» Prescription (brand) $185

4. Eye exam (in network) $45 10 4.5

5. Urgent care (out of network) $85 17 8.5

6. Prescription (generic, in network) $85 5 5

7. Prescription (brand, out of network) $225 56.25 5

8. Annual physical (in network) $95 5 9.5

9. Emergency room for snowboard accident

25 0
(concussion, broken leg, X-rays, etc.) $6,500

10. Urgent care (in network) $105 10 10.5

FO U N DATI O NS I N PERSONA L FI NA NCE PAGE 1 O F 3

 Health Plan Comparison Sheet
SERVICE
HEALTH CHOICE SUPER HEALTH
AND COST

90% of approved amount after

Emergency
$25 co-pay deductible; 100% of approved amount
Room for accidental injury

In Network: $10 co-pay; 100% for initial

exam for accident/medical emergency
Out of Network: 80% of approved
Urgent Care 90% of approved amount after deductible
amount after deductible, 100% of
approved amount for initial exam for
accident/medical emergency

In Network: 100% of approved amount

Surgery Out of Network: 80% of approved 100% of approved amount
amount after deductible

In Network: 100% of approved amount

100% of approved amount plus $5 per
Hospital Care Out of Network: 80% of approved day for private room
amount after deductible

In Network: Co-pay $5 generic/$10 brand

Prescriptions Co-pay $5 generic/brand
Out of Network: 75% of approved amount

In Network: $5 co-pay; 100% approved

amount for initial exam for injury/
medical emergency
Physician 90% of approved amount after
Out of Network: 80% of approved
Office Visit deductible;100% for accidental injury
amount after deductible; 100% approved
amount for initial exam for injury/
medical emergency

In Network: $10 co-pay for one exam per

calendar year
Vision 90% of approved amount after deductible
Out of Network: 80% of approved
amount after deductible

In Network: None
Deductible Out of Network: $250 individual per $250 per calendar year
calendar year

In Network: None
Maximum
Out of Network: 100% after payments 100% after payments reach $1,000
Out of Pocket
reach $2,500

FO U N DATI O NS I N PERSONA L FI NA NCE PAGE 2 O F 3

 Health Coverage Comparison
CHAPTER 9, LESSON 4

DIRECTIONS
Answer the following questions and be ready to discuss your answers with the class.

1. How much total money would you have spent out of pocket with each plan?
None with health choice but 100% if up to $1000 with super health.

2. With each plan, how much total money would you have to spend before the insurance
coverage pays 100% of your medical costs?
up to $25 co-pay with health choice

3. What is the purpose of health insurance?

To cover expected and unexpected expected to make health care for afordable

4. Why is it important for young adults to understand the role of health insurance?
So they know what they need to get

FO U N DATI O NS I N PERSONA L FI NA NCE PAGE 3 O F 3