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This is the Premium dashboard for Maya, a sample member choosing between the three medical plans her employer offers. Premium members see this for their own plans.
Maya's Health Recommendations
1 Maya's answers
Also on file: health rated Very Good, no ongoing conditions. Every number below recalculates in your browser when you change coverage. The full Premium questionnaire has 10 short questions.
2 Her plans
HealthWise read three medical plans from her employer's benefits guide:
- Cascade Saver HSA · HDHP PPO
- Cascade Choice PPO · Copay PPO
- Northgate Essential HMO · Copay HMO
Uploading your own plan documents is part of Premium. This guide and every company in it are fictional.
Recommendation summary
Versus staying on Cascade Choice PPO ($11,155 in a typical year), switching saves about $3,815.
Picked because it costs the least in a typical year for this coverage. Educational information only, not licensed insurance advice.
Personalized insights
Best for low annual costs
Cascade Saver HSA
Best for families
Northgate Essential HMO
Best if major care is expected
Cascade Choice PPO
Estimated cost by scenario
Costs shown for family coverage. Lowest total in each scenario is highlighted.
Low utilization A healthy year - you barely use care. | Cascade Saver HSA HDHP PPO | Cascade Choice PPO Copay PPO | Northgate Essential HMO Copay HMO |
|---|---|---|---|
| Premiums | $5,640 | $9,600 | $6,120 |
| Copays (visits + Rx) | $86 | $45 | $20 |
| Toward deductible | $0 | $0 | $0 |
| Coinsurance | $0 | $0 | $0 |
| Out-of-pocket subtotal | $86 | $45 | $20 |
| Total for the year | $5,726 💰 lowest | $9,645 | $6,140 |
Average adult A typical year for an average adult. | Cascade Saver HSA HDHP PPO | Cascade Choice PPO Copay PPO | Northgate Essential HMO Copay HMO |
|---|---|---|---|
| Premiums | $5,640 | $9,600 | $6,120 |
| Copays (visits + Rx) | $676 | $355 | $170 |
| Toward deductible | $1,200 | $1,200 | $1,000 |
| Coinsurance | $0 | $0 | $50 |
| Out-of-pocket subtotal | $1,876 | $1,555 | $1,220 |
| Total for the year | $7,516 | $11,155 | $7,340 💰 lowest |
High utilization Frequent care - many visits, imaging, a minor procedure. | Cascade Saver HSA HDHP PPO | Cascade Choice PPO Copay PPO | Northgate Essential HMO Copay HMO |
|---|---|---|---|
| Premiums | $5,640 | $9,600 | $6,120 |
| Copays (visits + Rx) | $2,332 | $1,260 | $690 |
| Toward deductible | $6,400 | $2,500 | $1,000 |
| Coinsurance | $1,120 | $1,900 | $2,750 |
| Out-of-pocket subtotal | $9,852 | $5,660 | $4,440 |
| Total for the year | $15,492 | $15,260 | $10,560 💰 lowest |
Critical illness A major event - surgery or hospitalization. | Cascade Saver HSA HDHP PPO | Cascade Choice PPO Copay PPO | Northgate Essential HMO Copay HMO |
|---|---|---|---|
| Premiums | $5,640 | $9,600 | $6,120 |
| Copays (visits + Rx) | $3,222 | $1,760 | $1,010 |
| Toward deductible | $6,400 | $2,500 | $1,000 |
| Coinsurance | $14,720 | $15,500 | $19,750 |
| Out-of-pocket subtotal | $13,000 OOP max reached | $6,000 OOP max reached | $11,000 OOP max reached |
| Total for the year | $18,640 | $15,600 💰 lowest | $17,120 |
Estimated costs computed from each plan's parsed terms for a family's care in each scenario - an educational estimate, not a quote. “Out-of-pocket subtotal” is copays + deductible + coinsurance, capped at the plan's out-of-pocket maximum.
Suggested learning
Ask HealthWise
Pick a question to see how HealthWise answers from the plans on file.
What would a typical year cost our family on each plan?
Counting premiums plus what you would pay for care in a typical year: Northgate Essential HMO comes to about $7,340, Cascade Saver HSA about $7,516, and Cascade Choice PPO about $11,155.
Most of that gap is premium. The PPO's family premium is $800 a month, versus $510 for the HMO and $470 for the HSA plan.
These answers are pre-written for this sample, based on the family coverage in Maya's profile. In Premium, you ask anything in your own words and answers come from your own plan documents. Educational information only, not licensed insurance advice.
See this for your own plans
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HealthWise provides educational information only, not licensed insurance, financial, or medical advice. The member, employer, and plans on this page are fictional samples. Questions? sales@healthwise.us.com