Maya, 27

One adult · $389/mo

"Broke her ankle snowboarding"

Just aged off her parents' plan. One adult, non-tobacco: $389/mo. Healthy, uses her $0 DPC visits for the usual stuff — a sinus infection, an annual physical. In March she breaks her ankle snowboarding. She contacts the Health Plan before the ER even discharges her, they walk her through it, and her total out-of-pocket for the entire incident — ER, imaging, orthopedic follow-up, the boot — is capped at her plan's deductible. Everything else on that incident is paid at 100%.

The Ortiz Family

Two adults + up to 3 children · $1,196/mo

"Healthy year, used it anyway"

Four people, parents in their mid-30s. Two adults + up to 3 children, non-tobacco: $1,196/mo. No major event this year. They lean on the $0 DPC visits for two kids' worth of sick days and sports physicals — their own annual physicals are $0 through DPC too — and submit for reimbursement on routine bloodwork ($95), a gym membership ($45/mo), and a round of counseling for their teenager. The takeaway: for a family that's mostly healthy, the $0 medical home access alone can be worth more than the monthly cost in a given year.

David, 43

Adult + spouse · $884/mo

"Knee surgery, deductible-only cost"

Entrepreneur, with his spouse. Adult + spouse, non-tobacco: $884/mo. He went self-employed two years ago and dropped his marketplace plan over cost. In the fall his spouse needs knee surgery for a torn meniscus. They contact the Health Plan first, get routed to a self-pay-friendly surgical center, and their total out-of-pocket for the surgery and follow-up PT is capped at their plan's deductible — the plan pays 100% of the rest for that incident.