Meet Rosa

Rosa and her family get their annual physicals, and she doesn’t use tobacco products. They use in-network doctors and pharmacies. But this is a tough year due to serious health conditions and a sports injury. 

Let’s take a look…

Cost

Rosa gets her physical and the kids get their immunizations.

$150 x 4
100% paid by the Company!

All the kids get sick a few times. Each time they receive several generic prescriptions to help them get better.

$150 visit x 6
$25 generic x 15

Rosa sees a specialist every month for an ongoing condition. She also fills one generic and one preferred brand prescription by mail order four times to help her manage it.

$250 visit x 12
$20 generic mail order x 4
$500 preferred brand mail order x 4

Cost

Rosa’s daughter is rushed to the ER and diagnosed with a serious condition. She’s admitted to the hospital for two days of monitoring.

$2,000 visit x 1
$20,000 hospital stay

Her daughter is getting worse, so her specialist schedules her for surgery.

$35,000 surgery

Rosa’s son is injured playing sports and needs several physical therapy visits to recover.

$150 visit x 8

Rosa gets sick and goes to the ER. She is prescribed a generic prescription to recover. She fills it at the pharmacy twice.

$2,000 visit x 1
$25 generic x 2

Rosa’s total expenses

Rosa has incurred a total of $67,205 in expenses. Now, let’s see which plan would have been better for Her.

$67,205

in total expenses

Wait!

Rosa has also been paying for medical coverage from Her paycheck and contributing to Her HSA. We’ll add that in.

Remember, Rosa incurred $67,205 in total expenses.

In all three plans, Rosa’s family reaches an out-of-pocket maximum, then the plan covers the rest of that care at 100% for the remainder of the year.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Rosa
$14,000
$10,000
$11,170
Paycheck deductions
$3,727
$4,418
$6,066
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided HSA contributions
($1,000)
($1,000)
N/A

And the winner is...

The HSA Value is the winner for Rosa!
HSA Core
HSA Value
Copay PPO
Costs paid by
 
Rosa
$14,000
$10,000
$11,170
Paycheck deductions
$3,727
$4,418
$6,066
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided HSA contributions
($1,000)
($1,000)
N/A
Rosa
’s
 total cost
$17,727
$14,418
$17,236

For more information about the LSC Medical Plans, review the Benefits eGuide. Remember, this is an example and your actual costs may vary.