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Original Question
Case Study 1 – Young Adult It seems like just yesterday that Zach was a freshman in college and battling mononucleosis, but he has just turned 26 and graduated from the OSU PharmD program. Zach is single and lives in Columbus (zip 43221). He has accepted a part-time job working directly for a pharmacy consultant who, because he is a small business employer, does not offer health care insurance. And because Zach is 26, he can’t stay on his parents’ plan. Zach wants to be sure he has coverage for his physical and financial wellbeing. Zach has decided to select a plan from the Affordable Care Act Health Insurance Marketplace (www.healthcare.gov). He anticipates his annual gross income will be $40,000 in salary, which he hopes will qualify him for a government subsidy. Zach is a nonsmoker and has a couple of health issues. Because he needs to see a couple of doctors annually and get prescriptions for acne and allergies, he expects his use of medical services will be “medium” next year. His health care provider and the prescription drugs he currently uses are: Primary care provider: Kara E Chidester, MD, Columbus, OH Acne medication: clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel (brand name: Ziana) Allergy medication: montelukast 10 MG Oral Tablet (brand name: Singulair) Questions Visit https://www.healthcare.gov/see-plans/#/?year=2024 to access the HealthCare.gov 2024 Health Insurance Plans and Prices website. Based on information in the case study, answer the questions on the next set of screens to find the list of available health care plans for Zach. Stop when you get to the web page that shows the Estimated savings overview. How much will Zach save on his health care premiums each month if he purchases insurance through the Health Insurance Marketplace? This answer has been provided for you to make sure you’ve answered the questions correctly. Estimated premium tax credit: $187 (If you get $224, you are in the 2025 plans; use the link above for 2024 for this exercise) Click View Plans. On the next page (Help comparing plans window), click Next. You should now see the Fast facts: Plan categories window. Which level of plan will give Zach the lowest average premiums: Bronze, Silver, or Gold? In addition to the lower monthly premium, what are the other ways Zach’s costs will be different from the other plan levels? Click See All Plans. You should now be on the View health & dental plans page. Since Zach knows he wants a low premium, click Add filters, check Bronze for the Health Plan Categories, and click Apply Filters at the bottom. Use the Add more filters feature to add Zach’s doctor and two prescription medications. Be sure to use the generic names, as brand name can be much more expensive; your selection should not have the brand name in [ ]. After adding Zach’s doctor and prescription drugs, click Add more filters again and make sure the boxes next to the provider and drugs are checked, then click Apply Filters. Which plan will charge Zach the lowest estimated monthly premium, and how much will that be? Be sure to check that Zach’s doctor is in-network and his drugs are covered. If there’s more than one plan at the same premium level, please select just one. What is the annual deductible? Plan Name: Estimated monthly premium: Annual deductible: Which plan (if more than one, select one) will require Zach to pay the lowest annual deductible, and how much will that be? What’s the monthly premium? You can re-sort by lowest deductiblenear the top of the webpage. Plan Name: Estimated monthly premium: Annual deductible: Why do you think the premium is higher when the deductible is lower? Next, click Add yearly cost (located to the right of any of the plan premiums, below Estimate total yearly cost), then select the level of care according to the case study. Next click Save And Continue. Now when you look at the individual plans you will see an Estimated total yearly costfor each plan. Which plan (if more than one, select one) will charge Zach the lowest estimated yearly costs? You can sort by Estimated yearly cost near the top of the page. Plan Name: Estimated total yearly costs: Now compare the three plans you selected in questions 3, 4, and 6. Check Compare for each of the plans, and then click Compare 3 Plans at the top of the screen. List five differences you see between the plans that might be important to Zach. Differences: Would you recommend that Zach selects the plan with the lowest premium, lowest deductible, lowest estimated yearly cost, or would you recommend considering another plan? Why? Provide at least three reasons.
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