Meet Jack & Diane They are empty nesters, with their kids all aged off of their medical plan. They're active and reasonably healthy with just a few medical services needed each year. Annual medical services: ACTUAL COST In their plan year, both Jack GOLD PLAN SILVER PLAN and Diane get their annual physical. There is no cost to the Jack & Diane Pay Jack & Diane Pay member for preventive services. Annual physical x6 $0 $0 $0 Jack sees a cardiologist twice a Cardiologist office visit x2 $460 ($230/visit) $35 copay x2 $105 copay x2 year and takes a regular Tier 2 medication Heart medication x12 $420 in copays/year $35 copay x12 $35 copay x12 Jack receives an Echocardiogram test $2,800 $500 ded; $100 copay $750 ded; $205 coinsurance echocardiogram test Orthopedic office visit $230 $35 copay $105 copay Diane sees an orthopedic specialist for a knee injury and Pain medication x4 $80 in copays/year $20 copay x4 $20 copay x4 is prescribed a Tier 1 medication to manage the pain Orthopedic surgery $3,500 $250 ded; $500 copay $375 ded; $312 coinsurance PCP office visit $150 $25 copay $30 copay Diane later elects to have outpatient knee surgery Overall cost of services Overall cost of services Deductible $750 $1,125 Diane visits her PCP for an office visit Coinsurance $0 $517 Copays $1,230 $635 Annual Payroll Deductions $6,180 $4,860 If you have no medical claims / year / year $8,160 $7,137 all year, you will save $1,320 in payroll deductions by *ABC's family deductibles are embedded, meaning no single individual on a family plan Save $1,023 on this plan will have to pay a deductible higher than the individual deductible amount. The two- selecting the silver plan person amount for the gold plan is $750, and the silver plan is $1,125.