Meet Patel

Patel and his family get their annual physicals and they don't use tobacco products. They use in-network doctors and pharmacies. This year he and the family get sick several times, and it turns out to be a bumpy year.

Let's take a look…

Cost

All of the family members get their physicals and the kids get their immunizations.

$125 visit x 4

100% paid by the company!

Patel sees a specialist twice for an ongoing condition. The doctor gives him two generic medications that he fills at the pharmacy. They do not work, so the doctor switches him to a preferred brand medication that he fills at the pharmacy.

$200 visit x 2

$25 generic x 2

$275 preferred brand x 1

Patel's wife and son are prescribed medications for the year. Patel fills the prescriptions at the pharmacy then switches to mail order.

$25 generic x 4

$70 generic mail order x 6

Cost

Everyone gets sick a few times. Each time they receive multiple generic prescriptions to help them get better.

$100 visit x 10
$20 generic x 22

Patel's condition gives him trouble throughout the year and he has three trips to urgent care. He gets three X-rays at outside imaging facilities.

$250 visit x 3

$300 X-ray x 3

Patel's daughter breaks her arm on the playground. The break is serious and requites out-patient surgery. The doctor gives her a generic prescription to manage the pain.

$5,000 surgery
$20 generic x 1

Patel does physical therapy for a few months to help manage his condition.

$115 visit x 6

Patel's total expenses:

Patel has incurred a total of $12,910 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$12,910

in total expenses

Wait!
We also need to remember that Patel has been paying for medical coverage from His paycheck too. We'll add that in.
Remember, Patel incurred $12,910 in total expenses from providers and services.

In the HSA plan, Patel 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
 
Patel
Paycheck contributions
Company contributions
N/A
($500)

And the winner is...

The PPO plan is the winner for Patel!

In the HSA plan, Patel 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
 
Patel
Paycheck contributions
Company contributions
N/A
($500)
Patel
's
 total cost