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 all three plans, Nathan meets the deductible and pays coinsurance for the rest of his care.

Gold
Silver
Bronze
Costs paid by
 
Nathan
$3,003
$5,215
$9,620
Paycheck contributions
$7,161
$3,673
$2,197
Company contributions
$0
($1,000)
($1,000)

And the winner is...

The Silver plan is the winner for Nathan!

In all three plans, Nathan meets the deductible and pays coinsurance for the rest of his care.

Gold
Silver
Bronze
Costs paid by
 
Nathan
$3,003
$5,215
$9,620
Paycheck contributions
$7,161
$3,673
$2,197
Company contributions
$0
($1,000)
($1,000)
Nathan
's
 total cost
$10,164
$7,888
$10,817
To see a more detailed breakdown of Nathan's care, click here. Remember, this is an example; your costs may vary.