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Case Facts

Amy and John have had excellent medical expense coverage under their employer's traditional indemnity medical expense plan.  Each is covered separately and pays a monthly premium of $45.  However, the cost of the plan to their employer has skyrocketed and the current plan is being eliminated.  They will now have a choice of three alternative plans with the following monthly costs:

  • An HMO with a monthly employee cost of $30
  • A point-of-service plan with a monthly employee cost of $75
  • A PPO plan with a monthly employee cost of $130

Amy and John see the same primary care physician and are in excellent health. Although John is willing to change physicians if necessary, Amy would prefer not to. She also would be very reluctant to change her gynecologist. Both are aware of the need to visit specialists because Amy's mother recently had breast cancer and John's mother has diabetes. Amy and John value their ability to visit a specialist of their choice.

Case Analysis

What factors should Amy and John evaluate in selecting a new medical expense plan?

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