Medical Scenarios to Help You Grow Your Knowledge

Emily is having a baby.  The estimates below include an uncomplicated vaginal delivery without sterilization, and a hospital stay of three nights for Emily and her baby. Emily and her newborn are the only people covered by her health plan option. 

These estimates include the deductible and coinsurance limits for Emily and baby. With the inclusion of the baby's estimated costs and associated deductible and coinsurance limits, the estimate you see here may appear higher than the deductible and coinsurance limits listed in the medical plan details. Check your plan benefits for specific details.

Here are Emily's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

Here are cost estimates for Emily's delivery.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for inpatient hospital service
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Emily's Costs:

Newborn's Costs:

** No deductible for newborn; Emily has already met the family deductible.

Total Costs and Annual Premiums: Factoring in annual premiums, Emily's projected costs for the year she delivers a new baby would be:

*** Emily was Employee Only prior to her baby being born; her HSA employer contribution would be for Employee Only as of the beginning of the year, and her premiums would change to Employee + Child level with her Qualifying Life Event.

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

Watch and listen to this NEW mini video of Daniel talking about how their having a baby influenced which health plan option he selected:

Bella lives by herself, and recently injured her foot and needs help figuring out what to do about it. The estimates below include a complete foot x-ray, with a minimum of three views. Some facilities may charge an additional fee for the radiologist to read the x-ray. Check your plan benefits for more details.

Here are Bella's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

Here are cost estimates for Bella's foot x-rays.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for non-preventive x-ray procedure
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Bella's Costs:

Total Costs and Annual Premiums: Factoring in annual premiums, Bella's projected costs for the year she injures her foot would be:

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

Mark's family is very concerned for him, as he just found out he has Type 1 diabetes. His doctor has prescribed a continuous glucose monitor for him. The estimates below include a continuous glucose monitor, receive, transmitter, and sensor, purchased through an in-network Durable Medical Equipment supplier. Check your plan benefits for more details.

Here are Mark's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

Here are cost estimates for Mark's continuous glucose monitor, receive, transmitter, and sensor.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for Durable Medical Equipment service
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Mark's Costs:

Total Costs and Annual Premiums: Factoring in annual premiums, Mark's projected costs for the year he is diagnosed with Type 1 diabetes would be:

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

Robert and his wife Claire are on the UVA Health Plan, and Claire encouraged Robert to seek medical advice for a nagging back pain he hasn't been able to heal. His primary care physician recommends that Robert start physical therapy on his back immediately.

The estimates below are for physical therapy, therapeutic procedure, one or more areas. Check your plan benefits for more details.

Here are Robert's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

Here are cost estimates for Robert's physical therapy on his back; this is a per visit estimate.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for physical therapy, therapeutic procedure, one or more areas
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Robert's Costs:

Total Costs and Annual Premiums: Factoring in annual premiums, Robert's projected costs for the year he has back pain and seeks physical therapy would be:

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

Ken hasn't been feeling well lately, and decides to visit his primary care physician to discover what is troubling his body.

The estimates below are for a typical primary care established patient office visit. A typical office visit at your primary care physician's office would entail just the cost of the visit itself for low to moderate severity problems. Check your plan benefits for more details.

Here are Ken's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

*Mental Health outpatient treatment office visit offer the same member cost-share as Primary Care provider office visits.  

Here are cost estimates for Ken's primary care physician office visit.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for a typical primary care established patient office visit
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Ken's Costs:

Total Costs and Annual Premiums: Factoring in annual premiums, Ken's projected costs for the year he visits his primary care physician would be:

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

Watch and listen to this NEW mini video of Rachel talking about why she switched from Choice Health to Value Health during Open Enrollment:

Tim's right knee had been bothering him for a long time, and he finally decided to have it replaced. His total knee replacement includes most typical services, from admission to discharge, but does not include physical therapy after his knee replacement. Charges may vary greatly depending on the type of implant Tim receives.

Here are Tim's possible deductible, coinsurance, maximum out-of-pocket cost, and annual premiums, depending on health plan option. Included also is the HSA employee contribution for Basic Health participants.

Here are cost estimates for Tim's total knee replacement.

• These estimates below presume no prior deductible was met
• The estimates are for in-network providers only
• The estimates are for in-patient hospital services
• The estimates are for a typical primary care established patient office visit
• Your real costs will depend on the services you receive and how Aetna is billed by the doctor or health care facility
• We cannot guarantee the accuracy of any cost or estimate, as they can change without notification
• This information is solely for use in evaluating and estimating the out-of-pocket costs for services by a doctor or facility
• Basic Health members are responsible for the balance of their deductible and out of pocket expenses if/when the HSA funds have exhausted. 

Tim's Costs:

Total Costs and Annual Premiums: Factoring in annual premiums, Tim's projected costs for the year he has a total knee replacement would be:

These scenarios are pulled from Aetna's database. If you would like to create your own scenarios, visit Aetna’s website and click on “Log in/Register” to access these resources:​​​​​  

• Aetna Website: Offers a Find Care & Pricing tool option. This compares costs to give you real-time, personalized estimates and provides average in-network and out-of-network costs 

WDA offers step-by-step assistance directly in Workday. You can also review the Open Enrollment Workday Job Aid on the Workday Central webpage (behind NetBadge), "Happening Now" section.

A summary of how to review and elect your benefits in Workday is below:

• Navigate to Workday.
• In your Workday Inbox, click on the message titled "Open Enrollment Change: [Your Name] on 01/01/2024"; click on "Let's Get Started."
• Open Enrollment in Workday is organized into "tiles" for each benefit; you will see two sections, one for Health Care and Accounts, and one for Insurance. Each section has multiple tiles. You will start with Health Care and Accounts.
• You will have three edit options at the bottom of every tile:
  • Manage to make changes to a benefit you already have
  • Enroll to add a new benefit
  • View to see a benefit that is not editable in Workday (more on this further down)
• Select a tile and choose the edit option for that tile.
• Once you've selected or waived a benefit in the Health Care and Accounts section, click on Confirm and Continue -- this will take you to a separate window to select or waive eligible dependents for that benefit. Dependents previously enrolled who are eligible will show up automatically, you just need to select or waive each one of them.
• Click Save to update the benefit tile. This does NOT submit your elections, it just saves the individual benefit tile details you've selected. 
• Repeat the above process for all six Health Care and Accounts tiles.
• Workday now offers you a status update on which benefits you’ve touched: "Reviewed," "Updated" or blank if you haven't touched a benefits tile yet.

• Once you've completed the Health Care and Accounts section, move on to the Insurance section. You will see multiple tiles under Insurance.
• Select a tile and choose the edit option for that tile.
• Please note that some life insurance benefits are VIEWABLE in Workday but not changeable. Each of these tiles will direct you to where you need to go to make changes. Some of these changes may be outside of Workday.​
• Once all your benefits have been reviewed and edited as needed, attach any required documents such as birth certificate for new dependents, then click on Review and Sign -- here you can read the summary of what's you elected.
  • New Basic Health participants: Sign and submit the HSA Terms and Conditions authorization form on the Review and Sign page. This document authorizes Fidelity to open your HSA and is required to receive the 2024 employer contribution.
  • New Dependents: If you added new dependents during Open Enrollment (spouse or children), upload required documentation into Workday. You will see a Spousal Affidavit on the Review and Sign page.
• Click on the I Accept box, then click on Submit to complete your Open Enrollment process.
• Print this page or save it as a PDF.

You can make changes to your elections as long as the Open Enrollment period is open, even after you have submitted your elections.

• From the Benefits app in Workday, click on Change Open Enrollment
• You will be making changes to what has been previously submitted. Any changes made will need to be resubmitted. If you do not resubmit, the changes will be deleted and the previous submission will remain in effect.
• Move through the same tiles to elect or waive coverage.
• Once changes are complete, electronically sign at the bottom of the last page and press the Submit button.
• Print the new confirmation of benefits elections or save as a PDF.

Look for additional tasks in Workday related to your Open Enrollment elections:

• Dependents and Beneficiaries: If you changed your dependents or beneficiaries in Workday, look for possible additional action items in your Workday Inbox.