Juanita

Juanita is married, but her husband has coverage with his employer. She doesn’t use tobacco. Juanita is typically in good health, but she’s had a bit of a bumpy year.

Let’s take a look...

She gets her free annual wellness exam.

$250
100% paid by Energy Transfer!

She starts having trouble with a condition that hasn’t bothered her in years. She goes to her primary care doctor four times. He prescribes her several generic medications that she fills at the pharmacy.

$80 visit x 4
$30 generic x 3

Her condition worsens and she goes to the ER.

$800 visit

After her ER visit she sees a specialist four times. He orders one round of tests and prescribes her a couple of generic medications she fill through mail order.

$110 visit x 4
$500 labs
$50 generic x 2

The specialist determines that Juanita needs to have surgery. She spends one night in the hospital.

$12,000 surgery + hospital stay

Juanita sees a physical therapist six times to recover from her surgery.

$90 visit x 6

Juanita's total expenses:

Juanita has incurred a total of $15,040 in expenses. Now, let’s see which plan would have been better for Her!

$15,040
in total expenses.
Wait!

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

Remember, Juanita incurred $15,040 in total expenses.

In the CDHP, Juanita pays up to the out-of-pocket max. After that the Partnership pays 100%.

In the PPO, she pays some through copays and some through coinsurance until she meets her out-of-pocket max.

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

CDHP
PPO
Costs paid by
 
Juanita
$4,500
$3,997
Juanita
's paycheck deductions
 
$757
$1,828
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
And the winner is...

The CDHP plan is the winner for Juanita!

CDHP
CDHP
PPO
PPO
Costs paid by
 
Juanita
$4,500
$3,997
Juanita
's paycheck deductions
 
$757
$1,828
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
Juanita's Total Cost
$4,257
$4,257
$5,825
$5,825

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