Finding the Right Plan

When deciding which medical plan is the best fit for you and your family, it’s important to consider the total cost of coverage. This includes what you pay in premiums and what you pay providers.

While each medical plan covers in-network preventive care services in full, the medical plans vary on annual deductibles, copays, and levels of coinsurance. This means you may pay more out-of-pocket costs with one plan versus another.

Below are four examples of health care users that may best fit each plan. Always consider your personal health situation when making decisions on which plan is right for you.

Molly	Mark	Paula	Gabriel
Best Fit: Cigna CDHP with HSA	Best Fit: Cigna HMO	Best Fit: Kaiser HMO	Best Fit: SIMNSA HMO
Overall Health: Molly has no medical conditions.	Overall Health: Mark has high blood pressure and his wife has high cholesterol.	Overall Health: Paula is a mother to two active children.	Overall Health: Gabriel has a recurring prescription for asthma medication.
Age: 25	Age: 55	Age: 37	Age: 46
Coverage: Employee Only	Coverage: Employee + Spouse	Coverage: Family	Coverage: Employee + Spouse
Description: Molly is healthy and active and does not visit the doctor often (outside of regular preventive care visits).	Description: Mark likes the option of seeing a doctor from a large network of providers. Mark usually knows what he’s going to pay with predictable copays for most services.	Description: Paula has two children who make frequent visits to the doctor. She appreciates the convenience of using Kaiser providers for all services.	Description: Gabriel and his domestic partner are healthy and active. He has asthma and regularly fills a prescription for his medication. They both live in Mexico.
What Molly wants most in a plan: Coverage for regular preventive care visits Potential savings for the future	What Mark wants most in a plan: Predictable costs A large network of providers	What Paula wants most in a plan: Interconnected network of providers Predictable costs	What Gabriel wants most in a plan: Local providers Reasonable copays and premiums
Plan Selection: Molly chooses the CDHP Plan. Here’s why: USD’s HSA contribution helps offset the deductible and out-of-pocket costs. Since she rarely uses all the money in her HSA, the balance rolls over for future use and gains tax-free interest year after year.	Plan Selection: Mark chooses the Cigna HMO Plan. Here’s why: The copays for services are predictable so Mark usually knows what his out-of-pocket costs will be for covered services. Although relatively healthy now, Mark and his wife are preparing in case of emergencies by getting the plan that will provide flexibility in providers.	Plan Selection: Paula chooses the Kaiser HMO Plan. Here’s why: She lives near a Kaiser facility. Her out-of-pocket costs are usually predictable. She likes that her providers can access her medical records with ease since all of her doctors are within Kaiser. She likes the no-cost eye exams.	Plan Selection: Gabriel chooses the SIMNSA HMO Plan. Here’s why: He is a Mexican national and his doctors are all located in Mexico. His monthly insurance premium is the lowest of all the plans. Low prescription copays help him save money on his asthma medication.