Consumer Journey
by Rose DiVirgilio
1. Call DiVirgilio Benefit Resources
2. Estimation of Care
2.1. Summary of Benefits
2.1.1. What is your overall Deductible and Specific Service Related Deductibles
2.1.2. What you will pay and limitations
2.1.3. If you visit a health care provider’s office or clinic
2.1.3.1. You may have to pay for services that aren’t preventive
2.1.4. If you need drugs to treat your illness or condition
2.1.5. If you have outpatient surgery
2.1.6. If you have a hospital stay
2.1.7. If you are pregnant
2.1.8. If you need help recovering or have other special health needs
3. Understanding the Risk
3.1. Medical Encounter
4. Consumer Financial Exposure
4.1. Cost of Care Estimation
5. Limiting the Risk
5.1. Medical Insurance
5.2. Prescription Coverage
5.3. Network
6. Managing the Risk
6.1. Benefit Design
6.1.1. Deductibles
6.1.2. Coinsurance
6.1.3. Copays
6.1.4. Limitations
6.1.4.1. #visits
6.1.4.2. Quantity
6.2. Out of Pocket Maximums
6.2.1. Individual Exposure
6.2.2. Family Exposure