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

They all get their physicals and the kids get their immunizations.

$125 visit x 4

100% paid by the company!

Nathan sees a specialist twice for an ongoing condition. He receives two new brand-name prescription to help him better manage it and he fills them at the pharmacy twice and then switches to mail order (3-month supply).

$140 visit x 2
$275  x 1
$400 brand-name refill mail order x 3

Nathan takes his daughter to doctor to renew her allergy medication and he uses mail order to fill the prescription. (3-month supply)

$100 visit x 1
$85 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.

$100 visit x 6
$20 generic x 12

This is the year of the sports injury at Nathan's house. They rack up three trips to urgent care and get three X-rays at outside facilities.

$250 visit 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 and two of them have to be refilled.

$5,000 surgery
$20 generic x 3
$20 generic refill x 2

His son also has to do physical therapy for a few months after the surgery.

$80 visits x 6

Nathan's total expenses:

Nathan has incurred a total of $9,400 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$9,400

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 $9,400 in total expenses from providers and services.

In the HSA plan, Nathan 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
 
Nathan
$3,795
$5,054
Paycheck contributions
$5,148
$3,432
Company contributions
N/A
($500)

And the winner is...

The HSA plan is the winner for Nathan!

In the HSA plan, Nathan 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
 
Nathan
$3,795
$5,054
Paycheck contributions
$5,148
$3,432
Company contributions
N/A
($500)
Nathan
's
 total cost
$8,943
$7,736