Patel and her family get their annual physicals and they don't smoke. 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…
All of the family members get their physicals and the kids get their immunizations.
$125 x 4 = $500
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.
$200 visit x 2
$25 generic x 2
$275 brand-name 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
$70 generic x 6
Everyone gets sick a few times. Each time they receive multiple generic prescriptions to help them get better.
$125 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.
$250 visits x 3
$300 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.
$7,000 surgery
$25 generic x 1
Patel does physical therapy for a few months to help manage her condition.
$115 visits x 6
Patel has incurred a total of $9,445 in expenses from providers and services. Now, let’s see which plan would have been better for Her!
in total expenses
In the HSA plan, Patel pays for Her care out-of-pocket, while in the PPO plan, She pays copays for most of Her care.
And the winner is...
In the HSA plan, Patel pays for Her care out-of-pocket, while in the PPO plan, She pays copays for most of Her care.