Question
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.
- 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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