Meet Rosa

Rosa's and her family get their annual physicals, and she doesn't smoke. They use in-network doctors and pharmacies. But this is a tough year due to serious health conditions and a sports injury. 

Let's take a look…

Cost

Rosa gets her physical and the kids get their immunizations.

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

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

$125 visit x 6
$25 generic x 15

Rosa sees a specialist every month for an ongoing condition. She also fills one generic and one preferred brand prescription by mail order to help her manage it. She refills both prescriptions three times.

$200 visit x 12
$70 generic mail order x 4
$400 preferred brand mail order x 4

Cost

Rosa's daughter is rushed to the ER and diagnosed with a serious condition. She's admitted to the hospital for two days of monitoring.

$2,500 visit x 1
$6,000 hospital stay

Her daughter is getting worse so her specialist schedules her for surgery.

$20,000 surgery

Rosa's son is injured playing sports and needs several physical therapy visits to recover.

$115 visits x 8

Rosa gets sick and goes to the ER. She is prescribed a generic prescription to recover. She fills it at the pharmacy twice.

$25 generic x 2

Rosa's total expenses:

Rosa has incurred a total of $57,875 in expenses from providers and services. Now, let’s see which plan would have been better for Her!

$57,875

in total expenses

Wait!
We also need to remember that Rosa has been paying for medical coverage from Her paycheck too. We'll add that in.
Remember, Rosa incurred $57,875 in total expenses from providers and services.

In the HSA plan, Rosa pays for Her care out-of-pocket, while in the PPO plan, She pays copays for most of Her care.

Gold
Silver
Bronze
Costs paid by
 
Rosa
$6,340
$11,000
$13,211
Paycheck contributions
$7,086
$3,690
$2,227
Company contributions
$0
($1,000)
($1,000)

And the winner is...

The Gold plan is the winner for Rosa!

In the HSA plan, Rosa pays for Her care out-of-pocket, while in the PPO plan, She pays copays for most of Her care.

Gold
Silver
Bronze
Costs paid by
 
Rosa
$6,340
$11,000
$13,211
Paycheck contributions
$7,086
$3,690
$2,227
Company contributions
$0
($1,000)
($1,000)
Rosa
's
 total cost
$13,426
$13,690
$14,438
To see a more detailed breakdown of Rosa's care, click here. Remember, this is an example, your costs may vary.