Meet Gabrielle

Gabrielle is married. She and her husband don't use tobacco products and they get their annual physicals. They use in-network doctors and pharmacies; however, this is a rough year for the couple.

Let's take a look…

Cost

They both get their physicals.

$150 x 2
100% paid by the Company!

Her husband sees his doctor to renew his generic blood pressure prescription for the year. He uses mail order to fill it.

$150  visit x 1
$20 generic mail order x 4

Gabrielle has been putting off knee surgery for awhile. She goes to the doctor three times for knee pain and fills a generic prescription twice at the pharmacy.

$150 visit x 3
$25 generic retail x 2

Gabrielle's husband is in a car accident and is taken to the ER.

$2,000 visit

He is sent home from the ER, but a few weeks later, he ends up having surgery due to his injuries.

$20,000 surgery

Cost

Gabrielle's knee continues to bother her, so she goes to see a specialist several times. He prescribes her a generic medication for the pain that she fills at the pharmacy twice.

$250  visit x 4
$25 generic x 2

Gabrielle goes to physical therapy for a few months for her knee issue.

$150 visit x 8

Physical therapy doesn’t help, so her doctor schedules her for knee replacement surgery.

$30,000

After her surgery, Gabrielle sees the specialist two more times and goes to physical therapy for a few months to recover.

$250 visit x 2
$150 visit x 8

Gabrielle's total expenses

Gabrielle has incurred a total of $56,980 in expenses. Now, let’s see which plan would have been better for Her.

$56,980

in total expenses

Wait!

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

Remember, Gabrielle incurred $56,980 in total expenses.

In all three plans, Gabrielle meets the out-of-pocket maximum for care. In the HSA plans, she uses Lantern for surgical support for her knee replacement, which helped to reduce her out-of-pocket costs.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Gabrielle
$14,000
$7,650
$12,520
Paycheck deductions
$5,062
$6,583
$8,557
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided contributions
($1,000)
($1,000)
N/A

And the winner is...

The HSA Value is the winner for Gabrielle!
HSA Core
HSA Value
Copay PPO
Costs paid by
 
Gabrielle
$14,000
$7,650
$12,520
Paycheck deductions
$5,062
$6,583
$8,557
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided contributions
($1,000)
($1,000)
N/A
Gabrielle
's
 total cost
$19,062
$14,233
$21,077

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