Meet Sharon.

Sharon found out last year that she had cancer. The reality of cancer hit Sharon and her family hard, emotionally and financially. Sharon’s husband also has some on-going medical conditions. Last year, Sharon’s family paid the following in out-of-pocket medical expenses.

Deductible $ 500
Co-Insurance $2,500
Dr. Co-pays $ 450
Rx Co-pays $ 980
TOTAL $4,430

Sharon is responding to her cancer treatments, but will continue to require frequent doctor visits, prescriptions, and expensive procedures this year. By selecting a High Deductible Health Plan (HDHP) with 100% co-insurance, Sharon will be able to cap her out-of-pocket expenses at less than half of last year’s total. Unlike a traditional plan, Sharon’s H.S.A. compatible HDHP will count Sharon’s office and prescriptions expenses toward the Deductible/Out-of-pocket maximum. Once the Deductible/Out-of-pocket maximum is reached, the insurance plan will pay 100% of her covered expenses including doctor visits and prescriptions.

BEFORE the OUT-OF-POCKET MAX:
Individual pays 100% of discounted network costs for covered medical expenses, office visits and prescriptions.

BEFORE the OOP Max Individual Pays:
Office Visits 100%
Prescriptions 100%
Out-Patient Costs 100%
In-Patient Costs 100%
Emergency Room 100%
Urgent Care 100%
Out-of-pocket Max (Family) $2,200

AFTER the OUT-OF-POCKET MAX:
Insurance company pays 100% of discounted network costs for covered medical expenses, office visits and prescriptions.

AFTER the OOP Max Individual Pays:
Office Visits $ 0
Prescriptions $ 0
Out-Patient Costs $ 0
In-Patient Costs $ 0
Emergency Room $ 0
Urgent Care $ 0

SAVINGS COMPARISON:
Traditional PPO Plan $4,430
Estimated Payroll Tax on
OOP Expenses* $1,108
TOTAL $5,538
H.S.A. Plan $2,200
Estimated Payroll Tax
Savings on H.S.A. funds $ -550
TOTAL $1,650
TOTAL SAVINGS $3,888
*Assumes 15% Federal, 2.35% State, 7.65 FICA

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