Doug

Doug is married. He and his wife don’t use tobacco. Doug’s wife has Type 1 diabetes. She controls it with insulin but has some complications this year.

Let’s take a look...

They get their free annual wellness exams.

$500
100% paid by Energy Transfer!

Doug becomes ill a couple times in the year and the doctor sends out for lab work.

$80 visit x 2
$500 labs

He also has two prescriptions that he fills at the pharmacy.

$30 generic x 2

Doug’s wife has trouble with her diabetes and goes to her primary care doctor few times.

$80 visit x 4

Her doctor refers her to a specialist for additional treatment and he orders a round of lab work.

$110 visit x 10
$500 lab

Her condition worsens and she is hospitalized for six days.

$12,600 hospital stay

Doug’s wife takes a generic form of insulin that she fills through mail order.

$50 generic x 4

Doug's total expenses:

Doug has incurred a total of $15,940 in expenses. Now, let’s see which plan would have been better for Him!

$15,940
in total expenses.
Wait!

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

Remember, Doug incurred $15,940 in total expenses.

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

In the PPO, he doesn’t reach the out-of-pocket max. He pays some copays, his deductible and still continues to pay coinsurance.

Doug could have saved several thousand dollars by using SurgeryPlus to schedule His surgery!

Because Doug's wife has a large claim, the individual deductible and max out-of-pocket applies to her care.

CDHP
PPO
Costs paid by
 
Doug
$5,220
$4,557
Doug
's paycheck deductions
 
$1,225
$3,481
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
And the winner is...

The CDHP plan is the winner for Doug!

CDHP
CDHP
PPO
PPO
Costs paid by
 
Doug
$5,220
$4,557
Doug
's paycheck deductions
 
$1,225
$3,481
Partnership-provided Contributions
($1,000)
($1,500)
($2,000)
($2,000)
N/A
Doug's Total Cost
$4,945
$4,945
$8,038
$8,038

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