Meet Patel

Patel and his family get their annual physicals and they don’t use tobacco products. They use in-network doctors and pharmacies. This year he and the family get sick several times, and it turns out to be a bumpy year.

Let’s take a look…

Cost

All of the family members get their physicals and the kids get their immunizations.

$150 visit x 4
100% paid by the Company!

Patel sees a specialist twice for an ongoing condition. The doctor gives him two generic medications that he fills at the pharmacy twice. They do not work, so he switches him to a preferred brand medication that he fills at the pharmacy.

$250 visit x 2
$25 generic x 2
$700 preferred brand x 1

Patel’s wife and son are prescribed medications for the year. Patel fills the prescriptions at the pharmacy then switches to mail order.

$25 generic x 4
$20 generic mail order x 6

Cost

Everyone gets sick a few times. Each time they receive multiple generic prescriptions to help them get better. Patel fills them at the pharmacy.

$150 visit x 10
$25 generic x 22

Patel’s condition gives him trouble throughout the year. He has three trips to urgent care and gets three X-rays at outside imaging facilities.

$200 visit x 3
$125 X-ray x 3

Patel’s daughter breaks her arm on the playground. The break is serious and requires outpatient surgery. The doctor gives her a generic prescription to manage the pain. Patel fills it at the pharmacy.

$4,500 surgery
$25 generic x 1

Patel does physical therapy for a few months to help manage his condition.

$150 visit x 6

Patel’s total expenses

Patel has incurred a total of $10,520 in expenses. Now, let’s see which plan would have been better for Him.

$10,520

in total expenses

Wait!

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

Remember, Patel incurred $10,520 in total expenses.

In the HSA Value plan, Patel meets the deductible, then pays coinsurance for the rest of his family's care. In the HSA Core plan, he pays out-of-pocket for care, and in the Copay PPO plan, he pays copays for most of their care.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Patel
$9,920
$5,984
$5,880
Paycheck deductions
$5,888
$7,360
$11,040
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 Patel!
HSA Core
HSA Value
Copay PPO
Costs paid by
 
Patel
$9,920
$5,984
$5,880
Paycheck deductions
$5,888
$7,360
$11,040
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided HSA contributions
($1,000)
($1,000)
N/A
Patel
’s
 total cost
$15,808
$13,344
$16,920

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