Ellen

She is married with two young kids and one on the way. The family is generally in good health and she and her husband don’t use tobacco. Ellen has serious complications at the end of her pregnancy and the baby has surgery before being released.

Let’s take a look...

The family all get their wellness exams and the kids get their immunizations.

$1,000
100% paid by Energy Transfer!

The kids occasionally go to the doctor for ear and sinus infections. Her husband goes to the doctor when he gets the flu.

$80 visit x 10

They also fill eight generic prescriptions at the pharmacy and four generic through mail order.

$30 generic x 8
$50 generic x 4

Ellen has serious complications in the third trimester of her pregnancy and is put on in-hospital bed rest. She gives birth by C-section two weeks later.

$31,000 C-section & hospital stay

The baby has some complications and has surgery. He recovers in the NICU.

$17,000 neonatal surgery
$32,000 NICU stay

The baby has several specialist visits after being released from the hospital.

$110 visit x 8

Ellen's total expenses:

Ellen has incurred a total of $83,120 in expenses. Now, let’s see which plan would have been better for Her!

$83,120
in total expenses.
Wait!

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

Remember, Ellen incurred $83,120 in total expenses.

In the CDHP Ellen pays up to the out-of-pocket max. Then The Company pays 100%.

In the PPO, she pays some through copays and coinsurance up to the maximum out-of-pocket.

Ellen could have saved several thousand dollars by using SurgeryPlus to schedule Her surgery!

CDHP
PPO
Costs paid by
 
Ellen
$9,000
$8,000
Ellen
's paycheck deductions
 
$2,072
$5,165
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
And the winner is...

The CDHP plan is the winner for Ellen!

CDHP
CDHP
PPO
PPO
Costs paid by
 
Ellen
$9,000
$8,000
Ellen
's paycheck deductions
 
$2,072
$5,165
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
Ellen's Total Cost
$9,072
$9,072
$13,165
$13,165

To see a more detailed calculation of Ellen's care, click here.