Patel

Patel and her husband have two kids. They get their annual  physicals, and they don't smoke. They use in-network doctors and Preferred Medical and Wellness Providers when possible. This year, she and the family get sick several times. It turns out to be a bumpy year.

Let's take a look…

Provider Billed Cost
All of the family members get their physicals, and the kids get their immunizations.

$80 x 4 = $320
100% paid by the company!

During their annual physicals, Patel's husband's and son's primary care doctors renew their 90-day preventative medications for the year. Patel refills them both three more times.

$20 generic x 2
$85 generic x 6

Patel sees a specialist twice for an ongoing condition. The doctor prescribes two generic 30-day medications. They do not work, so he switches her to a preferred brand 30-day medication to try.

$140 visit x 2
$20 generic 30-day x 2
$275 brand-name x 1

Provider Billed Cost
Everyone gets sick a few times. Each time they go to their primary care doctor and receive multiple generic 30-day prescriptions to help them get better.

$100 visit x 8
$20 generic 30-day x 12

Patel's condition continues to give her trouble, and she has three trips to urgent care and gets three X-rays at outside imaging facilities.

$90 visits x 3
$150 X-ray x 3

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

$5,000 surgery
$20 generic 30-day x 1

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Patel's doctor decides that in addition to the medication she already takes, she needs to add physical therapy for a few months to help manage her condition.

$80 visits x 6

‍

Patel's total expenses:

Patel has incurred a total of $8,725 in expenses from providers and services. Now, let’s see which plan would have been better for Her!

$8,725
in total expenses.
back_hand
Wait! We also need to remember that Patel has been paying for medical coverage from Her paycheck too. We'll add that in.

Remember, Patel incurred $8,725 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)
Costs paid by
 
Patel
$4,432
$5,711
$4,511
$4,387
Paycheck
 
contributions
$6,110
$3,432
$3,432
$3,432
WFM PWA/HSA contributions
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
And the winner is...

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

National Select (PWA)
National Select (PWA)
National Choice (PWA or HSA)
National Choice (PWA or HSA)
Whole Health Plan (HSA)
Whole Health Plan (HSA)
Whole Health Plan (PWA)
Whole Health Plan (PWA)
Costs paid by
 
Patel
$4,432
$5,711
$4,511
$4,387
Paycheck
 
contributions
$6,110
$3,432
$3,432
$3,432
WFM PWA/HSA contributions
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
Total Costs
 
 
$9,542
$9,542
$7,643
$7,643
$6,443
$6,443
$6,319
$6,319

If Patel elects the National Choice or the Whole Health plan and pairs either plan with the HSA, she could also benefit from making pre-tax contributions to her HSA to use now or in the future.

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

Patel

Patel está casada y tiene dos hijos, por lo que el plan médico cubre a la familia. Se hacen los chequeos médicos anuales y no fuman. Acuden a médicos, farmacias y proveedores médicos y de bienestar preferentes dentro de la red siempre que es posible.

Este año tanto ella como la familia se enferman varias veces y resulta ser un año agitado. Echemos un vistazo…

Provider Billed Cost
Todos los miembros de la familia se hacen los chequeos médicos.

$80 x 4 = $320
¡La empresa paga el 100 %!

Durante los chequeos médicos anuales, los médicos de atención primaria del esposo y el hijo de Patel renuevan los medicamentos preventivos para 90 días para todo el año. Patel surte las recetas de ambos tres veces.

$20, genéricos x 2
$85, genéricos x 6

Patel acude dos veces a un especialista por un problema de salud crónico. El médico le receta dos medicamentos genéricos para 30 días. No le sirven, así que se los cambia por un medicamento de marca para 30 días.

$140, consulta x 2
$20, genéricos para 30 días x 2
$275, de marca x 1

Provider Billed Cost
Todos se enferman varias veces. Cada vez van a su médico de atención primaria y reciben varias recetas de medicamentos genéricos para 30 días, para que se mejoren.

$100, consulta x 8
$20, genéricos para 30 días x 12

Patel sigue teniendo problemas. Tiene tres consultas de urgencia y se hace tres radiografías en centros de diagnóstico por imágenes externos.

$90, consulta x 3
$150, radiografía x 3

La hija de Patel se fractura el brazo en el patio de recreo. Requiere cirugía ambulatoria. El médico le da una receta de medicamentos genéricos para 30 días para controlar el dolor.

$5,000, cirugía
$20, genéricos para 30 días x 1

El médico de Patel decide que, además de la medicación que le ha recetado, necesita añadir fisioterapia durante unos meses para controlar su problema de salud.

$80, consulta x 6

Patel's total expenses:

Patel ha incurrido en un total de $8,725 en gastos de proveedores y servicios. Veamos ahora qué plan hubiese sido mejor para Patel.

$8,725
en gastos totales
back_hand
¡Un momento! También debemos recordar que Patel ha estado pagando la cobertura médica con su salario. Agregaremos eso.

Remember, Patel incurred $8,725 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)
Costos a cargo de
 
Patel
$4,432
$5,711
$4,511
$4,387
Tarifas de Contribución
 
 
$6,110
$3,432
$3,432
$3,432
Contribuciones de WFM a la PWA/HSA
($500)
($1,000)
($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 Patel, ¡el National Choice Plan o el Whole Health Plan con la PWA son los indicados!

National Select (PWA)
National Select (PWA)
National Choice (PWA o HSA)
National Choice (PWA o HSA)
Whole Health Plan (HSA)
Whole Health Plan (HSA)
Whole Health Plan (PWA)
Whole Health Plan (PWA)
Costos a cargo de
 
Patel
$4,432
$5,711
$4,511
$4,387
Tarifas de Contribución
 
 
$6,110
$3,432
$3,432
$3,432
Contribuciones de WFM a la PWA/HSA
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
Costo anual total
 
 
$9,542
$9,542
$7,643
$7,643
$6,443
$6,443
$6,319
$6,319

Si Patel elige el plan National Choice o Whole Health y combina cualquiera de los planes con la HSA, también podría beneficiarse al hacer contribuciones antes de impuestos a su HSA para usar ahora o en el futuro.

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