Meet Patel

Patel and her family get their annual physicals and they don't use tobacco products. They use in-network doctors and pharmacies. This year she and the family get sick several times, and 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 x 4
100% paid by the Company!

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

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

Patel's husband 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 x 6

Cost

Everyone gets sick a few times. Each time they receive multiple generic prescriptions to help them get better.

$150 visit x 10
$25 generic x 22

Patel's condition gives her trouble throughout the year and she 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 requites out-patient surgery. The doctor gives her a generic prescription to manage the pain.

$4,500 out-patient surgery
$25 generic x 1

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

$150 visits x 6

Patel's total expenses

Patel has incurred a total of $11,020 in expenses. Now, let’s see which plan would have been better for Her.

$11,020

in total expenses

Wait!

Patel has been paying for medical coverage from Her paycheck too and contributing to Her HSA in those plans. We'll add that in.

Remember, Patel incurred $11,020 in total expenses.

In the HSA Value, Patel meets the deductible, then pays coinsurance for the rest of her family's care. In the HSA Core, hse pays out of her pocket for care and in the Copay PPO, she 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
$4,121
$5,449
$8,173
Company-provided contributions
($500)
($500)
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
$4,121
$5,449
$8,173
Employee HSA contributions
$0
$0
N/A
Company-provided contributions
($500)
($500)
N/A
Patel
's
 total cost
$13,541
$10,933
$14,053

For more information about the medical plans, review the Benefits Guide. Remember, this is an example, your actual costs may vary.