Meet Bill

Bill is single. He doesn’t use tobacco products and gets his annual physical. He uses in-network doctors and pharmacies, but he’s had a tough year.

Let’s take a look…

Cost

He gets his free annual physical.

$150 visit x 1
100% paid by the Company!

He starts to feel bad and goes to his primary care doctor several times. His doctor gives him a few generic medications that he fills at the pharmacy.

$150 visit x 6
$25 generic x 3

His problem gets worse, so he starts to see a specialist every week. During a few of his visits, he is sent to an outside facility for lab work.

$250 visit x 6
$100 labs x 3

Cost

His condition gets worse. He goes to the ER twice for shortness of breath.

$2,000 visit x 2

He ends up having inpatient surgery and staying in the hospital to treat his condition.

$35,000 surgery and hospital stay

He sees a physical therapist eight times to recover from his surgery and fills two new generic prescriptions through mail order.

$150 visit x 8
$20 generic mail order x 2

Bill’s total expenses

Bill has incurred a total of $43,165 in expenses. Now, let’s see which plan would have been better for Him.

$43,165

in total expenses

Wait!

Bill has also been paying for medical coverage from His paycheck and the Company contributed to His HSA. We’ll add that in.

Remember, Bill incurred $43,165 in total expenses.

Bill pays up to the out-of-pocket maximum in all three plans, then the rest of his care is covered at 100%.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Bill
$7,000
$5,000
$6,500
Paycheck deductions
$228
$1,023
$1,856
Company-provided HSA contributions
($500)
($500)
N/A

And the winner is...

The HSA Value is the winner for Bill!
HSA Core
HSA Value
Copay PPO
Costs paid by
 
Bill
$7,000
$5,000
$6,500
Paycheck deductions
$228
$1,023
$1,856
Company-provided HSA contributions
($500)
($500)
N/A
Bill
’s
 total cost
$6,728
$5,523
$8,356

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