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 visit 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 a while. 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 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 surgery

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 also been paying for medical coverage from Her paycheck and contributing to Her HSA. 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 helps 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 HSA 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 HSA contributions
($1,000)
($1,000)
N/A
Gabrielle
’s
 total cost
$19,062
$14,233
$21,077

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