Rosa

Rosa and her two kids get their annual physicals, and she doesn't smoke. They use in-network doctors and Preferred Medical and Wellness Providers when possible. But this is a tough year due to serious health conditions and a sports injury.

Let's take a look…

Provider Billed Cost
Rosa gets her physical and the kids get their immunizations.

$80 x 3 = $240
100% paid by the Company!

All the kids get sick a few times. Each time they receive several generic prescriptions to help them get better.

$100 visit x 4
$20 generic 30-day x 8

Rosa sees a specialist monthly for an ongoing condition. The doctor gives her one generic 90-day and one preferred brand 90-day prescription to help her manage it. She refills both prescriptions three times.

$140 visit x 12
$85 generic 90-day x 4
$340 preferred brand 90-day x 4

Provider Billed Cost
Rosa's daughter is rushed to the ER and diagnosed with a serious condition. They send her home to monitor the condition.

$2,000 ER visit

Her daughter is getting worse, so her specialist schedules her for surgery. They keep her for two days for observation.

$15,000  surgery
$3,000 hospital stay x 2

Rosa's son is injured playing sports and needs several physical therapy visits to recover.

$80 visits x 12

Rosa's total expenses:

Rosa has incurred a total of $28,140 in expenses from providers and services. Now, let’s see which plan would have been better for Her!

$28,140
in total expenses.
back_hand
Wait! We also need to remember that Rosa has been paying for medical coverage from Her paycheck too. We'll add that in.

Remember, Rosa incurred $28,140 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
 
Rosa
$6,530
$10,415
$6,650
$6,650
Paycheck
 
contributions
$3,562
$1,976
$1,976
$1,976
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 Rosa is eligible for, the National Select 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
 
Rosa
$6,530
$10,415
$6,650
$6,650
Paycheck
 
contributions
$3,562
$1,976
$1,976
$1,976
WFM PWA/HSA contributions
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
Total Costs
 
 
$9,092
$9,092
$10,891
$10,891
$7,126
$7,126
$7,126
$7,126

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

Rosa

Rosa tiene a sus dos hijos cubiertos por el plan médico. Se hacen los chequeos médicos anuales, y ella no fuma. Acuden a médicos, farmacias y proveedores médicos y de bienestar preferentes dentro de la red siempre que es posible.

Este es un año difícil debido a graves problemas de salud y a una lesión deportiva. Echemos un vistazo…

Provider Billed Cost
Rosa y los hijos se hacen los chequeos médicos.

$80 x 3 = $240
¡La empresa paga el 100 %!

Los hijos se enferman varias veces. Cada vez reciben varias recetas de medicamentos genéricos para 30 días, para que se mejoren.

$100, consulta x 4
$20, genéricos para 30 días x 8

Rosa acude todos los meses a un especialista por un problema de salud crónico. Para ayudarla a controlarlo, el médico le da una receta de medicamentos genéricos para 90 días y otra de marca preferida para 90 días. Resurte ambas recetas tres veces.

$140, consulta x 12
$85, genéricos para 90 días x 4
$340, de marca preferida para 90 días x 4

Provider Billed Cost
Llevan a la hija de Rosa a la sala de emergencias y le diagnostican una enfermedad grave. La envían a casa para vigilar su estado.

$2,000, consulta en la sala de emergencias

El estado de su hija empeora, por lo que el especialista programa una cirugía y la mantiene dos días en observación.

$15,000, cirugía
$3,000, días de hospitalización x 2

El hijo de Rosa se lesiona al hacer deporte y necesita varias sesiones de fisioterapia para recuperarse.

$80, consulta x 12

Rosa's total expenses:

Rosa ha incurrido en un total de $28,140 en gastos de proveedores y servicios. Veamos ahora qué plan hubiese sido mejor para Rosa.

$28,140
en gastos totales
back_hand
¡Un momento! También debemos recordar que Rosa ha estado pagando la cobertura médica con su salario. Agregaremos eso.

Remember, Rosa incurred $28,140 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
 
Rosa
$6,530
$10,415
$6,650
$6,650
Tarifas de Contribución
 
 
$3,562
$1,976
$1,976
$1,976
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 Rosa, ¡el National Select Plan o el Whole Health Plan con 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
 
Rosa
$6,530
$10,415
$6,650
$6,650
Tarifas de Contribución
 
 
$3,562
$1,976
$1,976
$1,976
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
 
 
$9,092
$9,092
$10,891
$10,891
$7,126
$7,126
$7,126
$7,126

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