Sanjay

Sanjay's family is usually in good health. They don't use nicotine products, and they get their annual physicals. They use in-network doctors and Preferred Medical and Wellness Providers when possible. Except for a few expensive medications, they have a pretty smooth year.

Let's take a look…

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Provider Billed Cost
All of the family members get their physicals, and the kids get their immunizations.

$80 x 4 = $320
100% paid by the Company!

A few of them go to their primary doctors for the flu. The kids also go to the doctor a few times for sinus infections and colds. Each trip includes a few generic prescriptions.

$100 visit x 8
$20 generic 30-day x 12

Provider Billed Cost
Sanjay develops a condition and goes to see a specialist, who gives him a preferred brand medication. Sanjay fills a 30-day prescription twice.

$140 visit x 1
$275 preferred brand, 30-day x 2

His wife starts feeling ill, so she goes to her primary care doctor. After testing, the doctor prescribes her a generic 30-day medication that she fills three times.

$100 visit x 8
$100 test x 1
$20 generic 30-day x 3

Sanjay's total expenses:

Sanjay has incurred a total of $2,310 in expenses from providers and services. Now, let’s see which plan would have been better for Him!

$2,310
in total expenses.
back_hand
Wait! We also need to remember that Sanjay has been paying for medical coverage from His paycheck too. We'll add that in.

Remember, Sanjay incurred $2,310 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.

Surest Plan
National Select (PWA)
National Choice (PWA or HSA)
Whole Health Plan (HSA)
Whole Health Plan (PWA)
Costs paid by
 
Sanjay
$720
$1,280
$1,990
$1,990
$745
Paycheck
 
contributions
$5,538
$6,110
$3,432
$3,432
$3,432
WFM PWA/HSA contributions
N/A
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
And the winner is...

Depending on which plan Sanjay is eligible for, the National Choice or the Whole Health Plan with a PWA are the winners!

Surest Plan
National Select (PWA)
National Choice (PWA or HSA)
Whole Health Plan (HSA)
Whole Health Plan (PWA)
Costs paid by
 
Sanjay
$720
$1,280
$1,990
$1,990
$745
Paycheck
 
contributions
$5,538
$6,110
$3,432
$3,432
$3,432
WFM PWA/HSA contributions
N/A
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
Total Costs
 
 
$6,258
$6,390
$3,922
$3,922
$2,677

In most of the plans, the Whole Foods Market PWA/HSA contribution covers all or a large portion or all of the costs paid by Sanjay.

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

Sanjay

La familia de Sanjay goza de buena salud en general. No consumen productos con nicotina y se hacen los chequeos médicos anuales. Acuden a médicos, farmacias y proveedores médicos y de bienestar preferentes dentro de la red siempre que es posible. Salvo por algunos medicamentos costosos, tienen un año bastante tranquilo.

Echemos un vistazo…

Provider Billed Cost
Todos los miembros de la familia se hacen los chequeos médicos.

$80 x 4 = $320
¡La empresa paga el 100 %!

Algunos van al médico de atención primaria porque tienen gripe. Los hijos también van al médico algunas veces por sinusitis y resfriados. Cada consulta incluye unas cuantas recetas de medicamentos genéricos.

$100, consulta x 8
$20, genéricos para 30 días x 12

Provider Billed Cost
Sanjay presenta un problema de salud y acude a un especialista que le receta un medicamento de marca. Sanjay surte la receta para 30 días dos veces.

$140, consulta x 1
$275, medicamentos de marca para 30 días x 2

La esposa empieza a sentirse mal, así que acude a su médico de atención primaria. Después de hacerle unas pruebas, el médico le receta un medicamento genérico para 30 días que ella surte tres veces.

$100, consulta x 8
$100, pruebas x 1
$20, genéricos para 30 días x 3

Gastos totales de Sanjay:

Sanjay ha incurrido en un total de $2,310 en gastos de proveedores y servicios. Veamos ahora qué plan hubiese sido mejor para Sanjay.

$2,310
en gastos totales
back_hand
¡Un momento! También debemos recordar que Sanjay ha estado pagando la cobertura médica con su salario. Agregaremos eso.

Recuerde que Sanjay ha incurrido en un total de $2,310 en gastos de proveedores y servicios.

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.

Surest Plan
National Select (PWA)
National Choice (PWA or HSA)
Whole Health Plan (HSA: nivel preferente)
Whole Health Plan (PWA: nivel preferente)
Costos a cargo de
 
Sanjay
$720
$1,280
$1,990
$1,990
$745
Deducciones del cheque de paga
 
 
$5,538
$6,110
$3,432
$3,432
$3,432
Contribuciones de WFM a la PWA/HSA
N/A
($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 Sanjay, ¡el National Choice Plan o el Whole Health Plan con una PWA son los indicados!

Surest Plan
National Select (PWA)
National Choice (PWA or HSA)
Whole Health Plan (HSA: nivel preferente)
Whole Health Plan (PWA: nivel preferente)
Costos a cargo de
 
Sanjay
$720
$1,280
$1,990
$1,990
$745
Deducciones del cheque de paga
 
 
$5,538
$6,110
$3,432
$3,432
$3,432
Contribuciones de WFM a la PWA/HSA
N/A
($500)
($1,000)
($1,000)
($1,500)
($1,000)
($1,500)
($1,000)
($1,500)
Costo anual total
 
 
$6,258
$6,390
$3,922
$3,922
$2,677

En la mayoría de los planes, la contribución de Whole Foods Market a la PWA/HSA cubre en su totalidad o en gran parte los costos a cargo de Sanjay.

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