plans

Plan Comparison Worksheet

SNHP 220

Spring 2023

Please use the following three plans and answer the questions below. If you can’t find the answer, explain how you looked and why you can’t find it.

Plan 1

Cigna Connect

Plan 2

KP Platinum

Plan 3

Blue Choice HMO Young Adult

Premium

$310/month

$534/month

$208/month

Summary of Benefits and Coverage

Cigna Connect SBC

KP SBC

Blue Choice SBC

Prescription Drug List

Cigna Connect Prescription Drug List

KP prescription Drug List

Blue Choice Prescription Drug List

• Go to “Those who buy directly from Carefirst” and click on “Exchange formulary”

Provider Network

Cigna Connect Provider Network

• Pick Arlington County, VA (zip 22204)• Choose “enter as guest”

KP Provider Network

• Pick “Kaiser Permanente Added Choice POS”

Blue Choice Provider Network

• Choose “continue as a guest”• Choose BlueChoiceAdvantage network

Question 1:

Which plan covers Rubina Dolvane (located in Arlington, VA)? And how much will it cost to see her? How much do you have to pay before your plan starts paying (e.g., what is deductible for an individual)?

Question 2:

Which plans cover Eliquis (any strength), a brand-name drug, used to treat and prevent blood clots and how much does it cost for each plan? How much do you have to pay before your plan starts paying (e.g., what is deductible)?

Question 3:

For each plan how much will you pay for an HIV test?

Question 4:

Assume you are a young, relatively healthy single adult without children (so your health care utilization will consist of mostly primary care and preventive care) which plan would you choose and why?

plans

As healthcare costs continue to rise, comparing health insurance plans has become more important than ever. The Plan Comparison Worksheet provides an organized way to compare health plans, taking into account premium costs, benefits, provider networks, and prescription drug coverage. In this essay, we will use the Plan Comparison Worksheet to compare three different health insurance plans: Cigna Connect, KP Platinum, and Blue Choice HMO Young Adult.

The first question on the worksheet asks which plan covers Rubina Dolvane, who is located in Arlington, VA, and how much it will cost to see her. After reviewing the provider networks for each plan, we find that all three plans have providers in Arlington, VA. However, the cost of seeing Rubina Dolvane varies by plan. Under Cigna Connect, the deductible for an individual is $1,500, which means that Rubina Dolvane would have to pay $1,500 out of pocket before the plan starts paying. After the deductible is met, Rubina would be responsible for a $25 copay for primary care visits. KP Platinum has a $500 deductible and a $20 copay for primary care visits. Blue Choice HMO Young Adult has a $0 deductible and a $40 copay for primary care visits. Therefore, depending on how much Rubina expects to use healthcare services, she may want to choose a plan with a lower deductible or copay.

The second question asks which plans cover Eliquis, a brand-name drug used to treat and prevent blood clots, and how much it costs for each plan. After reviewing the prescription drug lists for each plan, we find that all three plans cover Eliquis. However, the cost of the drug varies by plan. Under Cigna Connect, the cost for a 30-day supply of Eliquis is $75. KP Platinum has a $0 copay for a 30-day supply of Eliquis. Blue Choice HMO Young Adult has a $45 copay for a 30-day supply of Eliquis. Depending on how much Eliquis Rubina needs, she may want to choose a plan with a lower copay or a plan that covers the drug at no cost.

The third question asks how much each plan charges for an HIV test. After reviewing the summary of benefits and coverage for each plan, we find that all three plans cover HIV tests at no cost to the patient. Therefore, Rubina could choose any of the three plans and not have to worry about the cost of an HIV test.

The final question asks which plan a young, relatively healthy single adult without children should choose. Based on the information provided, the Blue Choice HMO Young Adult plan may be the best choice for this individual. With a low monthly premium of $208 and a $0 deductible, this plan offers affordable coverage for primary care and preventive services. However, if the individual expects to use healthcare services frequently, they may want to consider a plan with a lower copay for primary care visits.

In conclusion, the Plan Comparison Worksheet is a valuable tool for comparing health insurance plans. By considering premium costs, benefits, provider networks, and prescription drug coverage, individuals can make an informed decision when choosing a health plan that meets their healthcare needs and budget.

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