Lexington Clinic

PPO or HDHP? Plan Chooser

The PPO and the HDHP use the same doctors. They differ in what comes out of your paycheck and what you pay when you get care. Tell us what you expect to use this year and see what each plan would cost you.

Plan year
Total compensation calculator

Who is covered

Part-time positions pay different paycheck deductions, which can change which plan costs less.

Which plans are you choosing from?

Anywhere plans are for employees who live 50 miles or more from 1221 South Broadway, Lexington. They use the Anthem national network with one set of costs and no Lexington Clinic preferred pricing.

Where do you usually get care?

Lexington Clinic providers are Tier 1 on both plans and cost the least. Hospital stays, emergency rooms and mental health visits are always priced at the Anthem network tier because Lexington Clinic does not provide them.

Care you expect this year

Count everyone on your coverage. Pick a starting point, then adjust any number.

Dollar amounts are the negotiated (allowed) cost of the service before insurance pays, not what you would owe. Rough guides: routine lab panel $150, X-ray $200, MRI $1,200, minor outpatient procedure $3,000 to $8,000, hospital delivery or major surgery $15,000 to $40,000.

What do deductible, copay, coinsurance and allowed amount mean?

Prescriptions

Ongoing medications you fill every month, by drug tier. You do not need to name them.

Specialty drugs are $0 on both plans through PrudentRx and are not included here.

Pre-tax accounts

Based on the care you entered, after tax savings

How the two plans compare as medical bills grow

PPOHDHP with HSA

How this is calculated
    Typical year shown

    The two plans at a glance

    Questions employees ask

    Plain answers about the Lexington Clinic plans. Official plan documents govern; the Benefits Department can confirm anything specific to you.

    Tips for choosing

    Rules of thumb that hold up for most people.

      Before you begin
      Cost for the year after tax savings
      PPO $0 vs HDHP $0
      See details