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Gabrielle

Gabrielle is married. She and her husband don't smoke, and they get their annual physicals. They use in-network doctors and Preferred Medical and Wellness Providers when possible. This is a rough year for the couple.

Let's take a look…

Provider Billed Cost

They both get their physicals.

$80 x 2 = $160
100% paid by the Company!

Her husband sees his primary care doctor to renew his generic prescription for the year. He gets the 90-day prescription filled four times.

$100 visit x 1
$85 generic 90-day x 4

Gabrielle goes to her primary care doctor three times for knee pain. The doctor gives her a generic 30-day prescription she fills two times.

$100 visit x 3
$20 generic 30-day x 2

Gabrielle's husband is in a car accident and is taken to the ER.

$2,000 visit

He is sent home from the ER, but a few weeks later, he has outpatient surgery due to his injuries.

$4,000 surgery

Provider Billed Cost

Gabrielle's knee continues to bother her, so she goes to see a specialist several times. He prescribes her a generic 30-day medication for the pain that she fills two times.

$140 visit x 4
$20 generic 30-day x 2

Gabrielle goes to physical therapy for a few months for her knee issue.

$80 visit x 8

Physical therapy doesn’t help, so her doctor schedules her for inpatient surgery with a two-day hospital stay.

$20,000 surgery
$3,000 hospital stay x 2

After her surgery, Gabrielle sees the specialist two more times and goes to physical therapy for a few months to recover.

$140 visit x 2
$80 visit x 8

‍

Gabrielle's total expenses:

Gabrielle has incurred a total of $35,100 in expenses from providers and services. Now, let’s see which plan would have been better for Her!

$35,100

in total expenses.

back_hand

Wait! We also need to remember that Gabrielle has been paying for medical coverage from Her paycheck too. We'll add that in.

Remember, Gabrielle incurred $35,100 in total expenses from providers and services.

Because the choice of funding account impacts the cost of care in the Whole Health plan, both the PWA and HSA options are shown here.

National Select (PWA)

National Choice (PWA or HSA)

Whole Health Plan (HSA)

Whole Health Plan (PWA)

$6,290

$10,660

$6,590

$6,650

$4,108

$2,288

($500)

($1,000)

($1,500)

($1,000)

($1,500)

($1,000)

($1,500)

And the winner is...

Depending on which plans Gabrielle is eligible for, the National Select and the Whole Health Plans with the PWA are the winners!

National Select (PWA)

National Choice (PWA or HSA)

Whole Health Plan (HSA)

Whole Health Plan (PWA)

$6,290

$10,660

$6,590

$6,650

$4,108

$2,288

($500)

($1,000)

($1,500)

($1,000)

($1,500)

($1,000)

($1,500)

$9,398

$11,448

$7,378

$7,438

Click here to view a detailed breakdown of the costs in each of the plans.

Gabrielle

Gabrielle está casada y su plan médico cubre al esposo. Ninguno de los dos fuma, y se hacen los chequeos médicos anuales. Acuden a médicos, farmacias y proveedores médicos y de bienestar preferentes dentro de la red siempre que es posible para recibir atención.

Este es un año difícil para la pareja. Echemos un vistazo…

Provider Billed Cost

Ambos se hacen los chequeos médicos.

$80 x 2 = $160
¡La empresa paga el 100 %!

El esposo acude a su médico de atención primaria para renovar su receta de medicamentos genéricos para todo el año. Surte la receta para 90 días cuatro veces.

$100, consulta x 1
$85, genéricos para 90 días x 4

Gabrielle acude tres veces a su médico de atención médica por dolor de rodilla. El médico le da una receta de medicamentos genéricos para 30 días que ella surte dos veces.

$100, consulta x 3
$20, genéricos para 30 días x 2

El esposo de Gabrielle sufre un accidente de coche y lo trasladan a la sala de emergencias.

$2,000, consulta

Lo envían a casa desde la sala de emergencias, pero unas semanas más tarde termina teniendo una cirugía ambulatoria debido a sus lesiones.

$4,000, cirugía

Provider Billed Cost

A Gabrielle le sigue molestando la rodilla, así que acude varias veces a un especialista. Para el dolor le receta un medicamento genérico para 30 días que ella surte dos veces.

$140, consulta x 4
$20, genéricos para 30 días x 2

Gabrielle hace fisioterapia durante unos meses por su problema de rodilla.

$80, consulta x 8

La fisioterapia no le sirve de nada, por lo que el médico le programa una cirugía con dos días de hospitalización.

$20,000, cirugía
$3,000, días de hospitalización x 2

Después de la cirugía, Gabrielle acude al especialista dos veces más y hace fisioterapia durante unos meses para recuperarse.

$140, consulta x 2
$80, consulta x 8

Gabrielle's total expenses:

Gabrielle ha incurrido en un total de $35,100 en gastos de proveedores y servicios. Veamos ahora qué plan hubiese sido mejor para Gabrielle.

$35,100

en gastos totales

back_hand

¡Un momento! También debemos recordar que Gabrielle ha estado pagando la cobertura médica con su salario. Agregaremos eso.

Remember, Gabrielle incurred $35,100 in total expenses from providers and services.

Dado que la elección de la cuenta de financiamiento repercute en el costo de la atención en el Whole Health Plan, aquí se muestran tanto la opción de la PWA como la HSA.

National Select (PWA)

National Choice (PWA o HSA)

Whole Health Plan (HSA)

Whole Health Plan (PWA)

$6,290

$10,660

$6,590

$6,650

$4,108

$2,288

($500)

($1,000)

($1,500)

($1,000)

($1,500)

($1,000)

($1,500)

Y el indicado es…

En función de los planes a los que puede acceder Gabrielle, ¡el National Select Plan o el Whole Health Plan con la HSA son los indicados!

National Select (PWA)

National Choice (PWA o HSA)

Whole Health Plan (HSA)

Whole Health Plan (PWA)

$6,290

$10,660

$6,590

$6,650

$4,108

$2,288

($500)

($1,000)

($1,500)

($1,000)

($1,500)

($1,000)

($1,500)

$9,398

$11,448

$7,378

$7,438

Haga clic aquí para obtener un desglose detallado de los costos en cada uno de los planes.