Meet Hannah

Hannah is married. She and her husband don't smoke and they get their annual physicals. They use in-network doctors and pharmacies. Her husband is diagnosed with a health condition.

Let's take a look…

Cost

They both get their physicals.

$125 x 2 = $250
100% paid by the Company!

Hannah and her husband take a generic allergy medication year-round. They fill their prescriptions through mail order (3-month supply).

$70 generic mail order x 2 x 4

After not feeling week for a few weeks, her husband goes to the primary care doctor. The doctor orders lab work from an outside facility.

$125 visit x 1
$75 labs x 1

He is diagnosed with a health condition and prescribed one generic and two name-brand medications. He fills them at the pharmacy.

$25  generic x 1
$275 brand-name x 2

Cost

Hannah gets sick and goes to her primary care doctor. He gives her two generic prescriptions that she fills at the pharmacy.

$125  visit x 1
$25 generic x 2

Her illness worsens over the weekend, so she goes to the urgent care. She's prescribed two new generic medications that she fills at the pharmacy.

$250 visit x 1
$25 generic x 2

‍

His condition worsens and his doctor hospitalizes him for two days.

$6,000 hospital stay

When he leaves the hospital his medication is changed to two generic medications that he fills twice through mail order.

$70 generic mail order x 2 x 2

Hannah's total expenses:

Hannah has incurred a total of $8,315 in expenses from providers and services. Now, let’s see which plan would have been better for Her!

$8,315

in total expenses

Wait!
We also need to remember that Hannah has been paying for medical coverage from Her paycheck too. We'll add that in.
Remember, Hannah incurred $8,315 in total expenses from providers and services.

In the Silver and Bronze plans, Hannah pays for her care out-of-pocket, while in the Gold plan, she pays copays for most of her care. Hannah meets the deductible in all three plans then pays copays and coinsurance for her care for the rest of the year.

Gold
Silver
Bronze
Costs paid by
 
Hannah
$1,935
$4,224
$5,728
Paycheck contributions
$9,560
$4,808
$2,592
Company contributions
$0
($1,000)
($1,000)

And the winner is...

The Bronze plan is the winner for Hannah!

In the Silver and Bronze plans, Hannah pays for her care out-of-pocket, while in the Gold plan, she pays copays for most of her care. Hannah meets the deductible in all three plans then pays copays and coinsurance for her care for the rest of the year.

Gold
Silver
Bronze
Costs paid by
 
Hannah
$1,935
$4,224
$5,728
Paycheck contributions
$9,560
$4,808
$2,592
Company contributions
$0
($1,000)
($1,000)
Hannah
's
 total cost
$11,495
$8,032
$7,320
To see a more detailed breakdown of Hannah's care, click here. Remember, this is an example; your costs may vary.