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Betsy has Type 2 diabetes and high blood pressure. She visits the doctor often to keep her diabetes and blood pressure controlled. The doctor regularly

Betsy has Type 2 diabetes and high blood pressure. She visits the doctor often to keep her diabetes and blood pressure controlled. The doctor regularly checks her blood levels and prescribes level 1 prescriptions to help Betsy control her diabetes and blood pressure. Betsy is considered a controlled diabetic. She uses her insurance plan frequently.

  1. Compare the plans provided and determine the best plan for Betsy. Remember to consider deductibles and general costs for the services she would be using.

Services

Bronze

Silver

Gold

Monthly cost

$163

$194

$245

Deductible

$6,000

$4,000

$1,000

Primary care

$35 co-pay for three visits, then 20% of co-insurance

$30 co-pay/provider/day

$20 co-pay/provider/day

Specialist visit

$70 co-pay for three visits, then 20% of co-insurance

$60 co-pay/provider/day

$40 co-pay/provider/day

Preventive care/screening/immunization

No charge

No charge

No charge

Diagnostic test (x-ray, blood work)

$35 co-pay or 20% of co-insurance if co-pay limit is reached

Office visit co-pay or 20% of co-insurance

Office visit co-pay or 20% of co-insurance

Level 1 prescription drugs

$25 co-pay/30-day supply

$15 co-pay/30-day supply

$15 co-pay/30-day supply

Emergency dept. services

20% of co-insurance

$350 co-pay/facility/day

$250 co-pay/facility/day

Emergency medical transportation

20% of co-insurance

20% of co-insurance

20% of co-insurance

Urgent care

$75 co-pay

$60 co-pay/provider/day

$60 co-pay/provider/day

Hospital stay (facility fee, physician/surgeon fee)

20% of co-insurance

20% of co-insurance

20% of co-insurance

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