Meet Nathan

Nathan has three children. He doesn't smoke, and they all get their annual physicals, but Nathan has an ongoing health condition. This is a bumpy year filled with injuries and medications. They use in-network doctors and pharmacies for their care.

Let's take a look…

Cost

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

$125 x 4 = $500
100% paid by the Company!

Nathan sees a specialist twice for an ongoing condition. He receives a new preferred brand prescription to help him better manage it and he refills them twice via mail order.

$200 visit x 2
$275 preferred brand x 1
$400 preferred brand mail order x 3

Nathan takes his daughter to doctor to renew her allergy medication and he uses mail order to fill the prescription.

$125 visit x 1
$70 generic mail order x 1

Cost

All the kids get sick a few times. Each time they receive multiple generic prescriptions to help them get better.

$125 visit x 6
$25 generic x 12

This is the year of the sports injury at Nathan's house. They rack up three trips to the urgent care and get three X-rays at outside facilities.

$250  visits x 3
$300 X-ray x 3

Nathan's son needs surgery to repair a badly injured knee. He is given three generic medications during his recovery.

$7,000 surgery
$25 generic x 3

His son also has to do physical therapy for a few months after the surgery.

$115 visits x 6

Nathan's total expenses:

Nathan has incurred a total of $13,085 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$13,085

in total expenses

Wait!
We also need to remember that Nathan has been paying for medical coverage from His paycheck too. We'll add that in.
Remember, Nathan incurred $13,085 in total expenses from providers and services.

In the HSA plan, Nathan pays for His care out-of-pocket, while in the PPO plan, He pays copays for most of His care.

Gold
Silver
Bronze
Costs paid by
 
Nathan
$3,003
$5,033
$9,620
Paycheck contributions
$7,086
$3,690
$2,227
Company contributions
$0
($1,000)
($1,000)

And the winner is...

The Silver plan is the winner for Nathan!

In the HSA plan, Nathan pays for His care out-of-pocket, while in the PPO plan, He pays copays for most of His care.

Gold
Silver
Bronze
Costs paid by
 
Nathan
$3,003
$5,033
$9,620
Paycheck contributions
$7,086
$3,690
$2,227
Company contributions
$0
($1,000)
($1,000)
Nathan
's
 total cost
$10,089
$7,723
$10,847
To see a more detailed breakdown of Nathan's care, click here. Remember, this is an example, your costs may vary.