Meet Sanjay and Ava and find out why they chose the Legacy PPO Plan.

Explore other plan options


Meet Sanjay

Sanjay has been suffering from knee pain for the last year, and he may need to have knee replacement surgery this year. He will need an MRI to determine if surgery is necessary. Even if surgery can be delayed, Sanjay may need to have injections and physical therapy to treat his symptoms throughout the year. He will also have his recommended preventive care, including an annual physical. He usually gets at least one sinus infection each year and takes several maintenance medications for his asthma.

What Sanjay Considers

Sanjay wants a plan that will provide the lowest out-of-pocket expenses when he receives care, and he’s willing to pay higher medical access fees during the year for that reassurance. His prescription costs are very low, so he’s not concerned about the expense of ongoing prescription copays should he meet the medical out-of-pocket maximum.

What Sanjay Decides and Why

Sanjay reviews the options available to him and elects the Legacy PPO plan.

He likes the convenience and predictability of copays for doctor's office visits, prescriptions, and other services that may come up during the year.

Sanjay also uses the Health Spending Account Estimator to project his total eligible out-of-pocket expenses—including dental and vision care. He decides to contribute $1,000 to his Health Care Flexible Spending Account to cover these costs. He knows that FSA balance won’t roll over at the end of the year like an HSA, but he is confident that he will spend the full tax advantaged amount.

For additional peace of mind, he decides to purchase MetLife's Critical Illness Insurance (CII), which pays a lump-sum benefit if he experiences a critical illness like cancer and certain other conditions.

Meet Sanjay

  • Gender: Male
  • Age: Over 50
  • Coverage for: Associate Only
  • Expected Health Care Needs: High