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Indiana State Personnel Department

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CDHP 1 and 2 vs. Traditional PPO

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Sample cases

Case #1 - The Jones' are a young couple with family health care coverage. Mrs. Jones is pregnant, expecting in September. The baby has a normal delivery in September with follow-up well baby visits at 2 weeks, 1 month, and 2 months, in the current year. Both Mr. and Mrs. Jones receive annual physicals. During their physicals both receive vaccines and have routine lab work performed. Mrs. Jones decides to have her baby at Community Hospitals Indiana. In September, Mr. Jones has  strep throat, which requires a doctor's office visit and is treated with a generic antibiotic. The Jones use only in-network providers. 

Case #2 - The Williams' are a middle-aged couple with family health care coverage. Both Mr. and Mrs. Williams have annual physicals which include vaccines and routine lab work. Mrs. Williams also has a routine annual mammogram. Late in January Mrs. Williams visits the local ER believing she is having a heart attack. This is ultimately diagnosed, after multiple tests, as an anxiety attack and she is released from ER and sent home. Between them, the Williams take three generic medicines for chronic conditions which are filled at a retail pharmacy. The Williams use only in-network providers for their health care needs.

Case #3 - Susan is a single, non tobacco user, individual enrolled in the state's health care program. She has an annual physical exam in January which includes routine lab work and vaccinations. She also has an annual mammogram in connection with her physical. Susan suffers from an arthritic condition which is managed with the drug ENBREL (a specialty drug). She has chosen to self-administer her treatment. Susan uses only in-network providers for her health care needs.