Meet Bill

Bill is single. He doesn't smoke and gets his annual physical. He uses in-network doctors and pharmacies, but he's had a tough year.

Let's take a look…

Cost

He gets his free annual physical.

$125 visit x 1

100% paid by the company!

He starts to feel bad and goes to his primary care doctor several times. His doctor gives him some generic medications that he fills at the pharmacy.

$125 visit x 6

$25 generic x 3

His problem gets worse, so he sees a specialist six times. During a few of his visits, he is sent to an outside facility for lab work.

$200 visit x 6

$75 labs x 3

Cost

His condition gets worse and he goes to the ER twice.

$2,000 visit x 2

He ends up having surgery for his condition.

$25,000 surgery and hospital stay

He sees a physical therapist eight times to recover from his surgery and fills two new generic prescriptions through mail order (3-month supply).

$80  visit x 8
$85 generic mail order x 2

Bill's total expenses:

Bill has incurred a total of $31,540 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$31,540

in total expenses

Wait!
We also need to remember that Bill has been paying for medical coverage from His paycheck too. We'll add that in.
Remember, Bill incurred $31,540 in total expenses from providers and services.

In the HSA plan, Bill pays for His care out-of-pocket, while in the PPO plan, He pays copays for most of His care.

PPO
HSA
Costs paid by
 
Bill
$3,500
$6,500
Paycheck contributions
$2,436
$1,452
Company contributions
N/A
($500)

And the winner is...

The HSA plan is the winner for Bill!

In the HSA plan, Bill pays for His care out-of-pocket, while in the PPO plan, He pays copays for most of His care.

PPO
HSA
Costs paid by
 
Bill
$3,500
$6,500
Paycheck contributions
$2,436
$1,452
Company contributions
N/A
($500)
Bill
's
 total cost
$5,936
$7,452