health incurans

Determine what your team would recommend to the following client:Timothy Griesdorn Jr. Age 27
Currently on 5 different medications, otherwise in good health. Total cost of prescriptions
without insurance is $1,000.
Lost medical insurance from parents, and will not be covered under medical insurance from his
employer until January, 2020. He can keep his current insurance, but would have to pay the
COBRA rate as follows:
COBRA coverage costs for Medical $850 per month, Dental $33 per month, and Vision $8 per
month. This policy has met its deductible and out of pocket maximum, so no other charges
would be incurred other than the premium payment. He has 60 days to decide if he wants
coverage, and up to 45 days to pay the premium.
He can also buy medical insurance from the health exchange (www.healthcare.gov).
29 different options are available, but many were able to be eliminated due to cost and coverage
concerns. Here’s a list of the options that you are considering:
Name
Monthly
Premium
$439.10
Deductible
$350
Out of Pocket
Maximum
$7,350
Oscar – Simple
Secure
Ambetter Secure
Care 1
$153.00
$7,350
$7,350
$395.57
$1,000
$6,350
Oscar – Classic
Gold
$359.07
$1,500
$7,350
Blue Cross Blue
Shield Silver
Advantage Plus
202
$493.80
$1,450
$7,350
Blue Cross Blue
Shield Gold
HMO 206
Other details about this client:
October – December, 2019 (3 months will not have insurance coverage)
Income $13 per hour – 40 hours per week.
Deductions $800 per month for taxes and child support
Copayments and
Coinsurance
3 $30 PCP visits
40% coinsurance
for prescription
drugs
No charges after
deductible.
3 free PCP visits
$25 per
prescription
$25 Dr. Visit
$50 per
prescription
2 free PCP visits
$10 per
prescription
Recommendation should include:
What insurance should be purchased, if any and when should he make the purchase. What are
the risks of not getting insurance? What would be the income tax penalty if he did not purchase
insurance? How did you determine what to recommend?