Meet Sanjay

Sanjay's family is usually in good health. They don't smoke, and they get their annual physicals. They use in-network doctors and pharmacies. Except for a few expensive medications, they have a pretty smooth year.  

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!

A few of them go to the doctor for the flu. The kids also go to the doctor a few times for sinus infections and a few rashes that won't go away. Each trip includes a few generic prescriptions.

$125 visit x 8
$25 generic x 15

Cost

Sanjay develops a condition that requires a preferred brand medication. Sanjay fills it twice at the pharmacy and the switches to mail order.

$275 preferred-brand x 2
$400 preferred-brand x 3

His wife starts feeling ill, so she goes to the to the doctor. After testing, the doctor prescribes her a generic medication. She fills it twice at the pharmacy then switches to mail order (3-month supply) for the rest of the year.

$125 visit x 8
$75 test x 1
$25 generic x 2
$70 generic x 3

Sanjay's total expenses:

Sanjay has incurred a total of $4,110 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$4,110

in total expenses

Wait!
We also need to remember that Sanjay has been paying for medical coverage from His paycheck too. We'll add that in.
Remember, Sanjay incurred $4,110 in total expenses from providers and services.

In the HSA plan, Sanjay 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
 
Sanjay
$845
$3,362
$3,610
Paycheck contributions
$12,303
$5,524
$3,018
Company contributions
$0
($1,000)
($1,000)

And the winner is...

The Bronze plan is the winner for Sanjay!

In the HSA plan, Sanjay 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
 
Sanjay
$845
$3,362
$3,610
Paycheck contributions
$12,303
$5,524
$3,018
Company contributions
$0
($1,000)
($1,000)
Sanjay
's
 total cost
$13,148
$7,886
$5,628
To see a more detailed breakdown of Sanjay's care, click here. Remember, this is an example, your costs may vary.